Background: Arthrotomy is considered the standard treatment for septic arthritis of the hip. This may be complicated by AVN or postoperative hip instability. Arthroscopic treatment of this condition is still not an established technique despite its minimally invasive nature and being associated with low morbidity.

Material and methods: A three portal arthroscopic technique was used for drainage, debridment and irrigation in 12 patients with septic coxarthrosis. Continuous intraarticular irrigation was not performed, nor was decompression drains used. All patients were treated with intravenous antibiotics for three weeks, followed with oral antibiotics for an additional minimum of three weeks.

Results: The patients were followed for 1–7 years. Staphylococcus aureus was identified in four of the six patients. All patients had a rapid postoperative recovery. The mean Harris Hip Score at the last review was 97.5 points. All patients had a full range of motion of the affected hip. No complications occurred with this group of patients.

Interpretation: Three directional arthroscopic surgery combined with large volume irrigation is an effective treatment modality in cases of septic arthritis of the hip. It is less invasive than arthrotomy, and offers low post surgical morbidity.

Introduction: Arthroscopy to debride osteochondral lesions (OCL) of the talus is an accepted procedure with a good outcome in 70–80% of subjects. The minority of subjects that do not do well present a problem. Further arthroscopy and debridement procedures have been assumed to yield poor results and this has been used as justification for cartilage transplantation. The evidence for this is lacking.

Methods: In our unit the routine procedure for OCL is arthroscopic debridement. If this fails a further arthroscopic debridement is performed. We identified all subjects who had had a repeat procedure for failed arthroscopic debridement of an OCL by the senior author and reviewed them clinically. The outcome was scored using the AOFAS hind foot and ankle scoring system.

Results: Between 1993 and 2002 808 ankle arthroscopies were performed of which 215 were to treat OCLs. Of these 12 had repeat arthroscopies because of a poor outcome. AOFAS scores improved from a mean of 34.8 to 80.5 at a mean follow up of 5.9 years (range 18 months – 11 years). One subject had already undergone a cartilage transplantation procedure because of a poor outcome. The other 11 subjects scored themselves as fair or good and had returned to previous levels of activity, including two professional sportsmen. It was clear by 6 months in all subjects that their symptoms were significantly improved following the second procedure.

Conclusions: This is the first series specifically assessing subjects who have had repeat arthroscopic debridement of OCLs of the talus. Our results disprove the assumption that repeat arthroscopic debridement yield poor results. It provides benchmark results at medium term follow up for cartilage transplantation to be compared to.