Microinstability of the hip: A review

Area of Science:

• Orthopedics
• Sports Medicine
• Hip Biomechanics

Background:

• Conservative hip surgery advances have revealed hip microinstability, characterized by painful, excessive hip joint mobility.
• This condition arises from combined architectural and functional abnormalities affecting hip joint stability.
• Risk factors include abnormalities in hip bone architecture and peri-articular soft tissues.

Purpose of the Study:

• To define hip microinstability, its causes, diagnostic methods, and treatment options.
• To highlight the multifactorial nature of hip microinstability and associated pathologies.
• To emphasize the importance of comprehensive clinical and imaging evaluation.

Main Methods:

• Diagnosis relies on patient interview, clinical examination, and advanced imaging techniques.
• Assessment includes evaluating hip joint bone architecture and peri-articular soft tissues (capsule, labrum, ligamentum teres).
• Differential diagnosis considers associated conditions like labral lesions and femoroacetabular impingement.

Main Results:

• Hip microinstability results from a combination of bony and soft tissue factors impacting joint stability.
• Associated lesions, such as labral tears or femoroacetabular impingement, may coexist with microinstability.
• Treatment strategies vary from conservative physiotherapy to surgical interventions like arthroscopy or osteotomy.

Conclusions:

• Hip microinstability is a complex, multifactorial condition where initial lesions can exacerbate the instability.
• Accurate diagnosis is challenging and necessitates a complete clinical and imaging assessment.
• Effective management requires addressing both the microinstability and any associated pathologies.