Over the last decades significant improvements both in diagnostics and treatment of hip disorders were achieved around the world and especially in Europe.

Based on registries and more detailed analysis osteoarthritis (OA) of the hip secondary to paediatric diseases is much more common than previously thought. Early diagnostic of DDH based on screening programs with application of ultrasound imaging of the new-born hip has shown to be effective with significant reduction of hospital stay and surgical interventions. Thus OA secondary to DDH will become less common.

Nevertheless, persistent dysplasia of missed and late cases may be diagnosed in adolescence or even later in early adulthood with and without clinical symptoms. Deformities after Legg Calvé Perthes disease, trauma, infection or skeletal dysplasia as well as slipped capital femoral epiphyses may need specific attention in the adolescent patient both in diagnostics and treatment.

Not only in Europe but also in North America there is a paradigm change and the treatment of slipped capital femoral epiphyses which has led to some controversy about the need of more radial open risky reduction procedures versus pinning in situ and waiting for remodeling.

Therefore, the adolescent hip is a “hot topic” and undoubtedly associated with an increase in interest and expertise in dealing with these difficult problems in a difficult age group.

The symposium “Preservation techniques for adolescent hip problems” will address well-established and new methods for diagnostic and therapeutic approaches to the various conditions.

Ch. Tschauner will address the need for specific information from the medical history, the problem oriented clinical examination and emphasize the imaging studies necessary to evaluate the pathologic condition especially if surgery is indicated and planned.

New MRI technologies are on their way to clinical routine showing promising data on intravital diagnostics  of the quality of cartilage tissue. Ch. Zilkens will present biochemical sensitive sequences in MRI and their application in paediatric hip diseases.

Once the pathology and the amount of deformity are defined treatment options especially osteotomies around the hip have to be considered and a decision algorithm should be applied to find the best surgical technique for the best correction of the pathology. R. Krauspe, F. Hefti and F. Grill will cover these topics on osteotomies at the femur, the pelvis and combined procedures.

Based on recent data about the risk of cartilage damage due to FAI (femoroacetabular impingement) the intraarticular correction has become popular in many centres. M. Leunig and Th. Slongo will report on recent achievements in the field of arthroscopy of the paediatric and adolescent hip and the indication and technique of open intraarticular procedures via surgical dislocation of the hip.

Some ground-breaking imaging and surgical technique have been devised and tried and tested but patient selection remains a key issue in ensuring that the right patient has the right result from the right treatment. Not many of the newer methods have in fact been tested over time and, as a profession, we must be careful not to fall into the trap of being too aggressive in our management of every case that presents to us with some hip pain.

Therefore, D. Eastwood will highlight the topic “Best practice versus experimental hype” to find out a solid scientific background for further evaluation of the various surgical techniques and different treatment options of adolescent hip problems.

Together with well-known experts from all over Europe I like to cordially invite all participants of the EFORT Congress in Berlin to this outstanding session. Hope to meet you in Berlin

Ruediger Krauspe, MD PhD
EPOS President