Atraumatic Hip Instability
Authors: Canham CD, Domb BG, Giordano BD
Journal: J Bone Joint Surg Rev
DOI: 10.2106/JBJS.RVW.15.00045
Purpose
To provide an overview of the pathophysiology, diagnosis, and management strategies for atraumatic hip instability.
Methods
Narrative literature review focused on the multifactorial causes of instability, including capsular laxity, structural abnormalities, and soft tissue injury.
Key Findings
- Diagnosis is often delayed due to subtle clinical signs.
- Capsular insufficiency and instability may be exacerbated by prior arthroscopy.
- Treatment includes arthroscopic capsular plication, reconstruction, or open procedures in severe cases.
Conclusions
Timely identification and tailored treatment of atraumatic hip instability can prevent functional decline and iatrogenic complications.
What Does This Mean for Providers?
- Maintain a high index of suspicion for instability in patients with vague hip pain and mechanical symptoms.
- Use dynamic imaging and provocative physical exams to aid in diagnosis.
- Avoid aggressive capsulotomy in at-risk patients; consider plication or reconstruction techniques for stabilization.