Down`s syndrome (Trisomy 21) is the most frequently seen chromosomal abnormality in humans. Before the developments in cardiovascular surgery, most of these patients were dying because of cardiovascular abnormalities; but nowadays, these patients` life-time expectancy is longer. Main mechanisms of musculoskeletal abnormalities that occur in these patients are muscle hypotonia and ligamentous laxity. As a result of these; instability, subluxation and dislocation can occur at upper servical spine, knees and hips.
Hip problems such as; dysplasia-subluxation and dislocation, slipped capital femoral epiphysis and avascular necrosis of the femoral head had been reported in this patient group. Hip joints are typically normal at birth but abnormal findings are seen at 2 to 10 ages. Hip pathology can occur up to 28% of adult patients. Hip instability can be treated either conservatively or surgically. It is emphasized that; anesthesiologists have to be aware of possible atlanto-axial instability; besides, plication of the hip capsule has to be added to osteotomies. Surgical site infection rates had been reported more than normal in this patient group; the results of treatment of the patients who have slipped capital femoral epiphysis are also worse. Thyroid gland dysfunction has to be investigated in patients with slipped capital femoral epiphysis.