Criteria for the Operating Room Confirmation of the Diagnosis of Hip Instability: The Results of an International Expert Consensus Conference
Authors: Safran MR, Murray IR, Andrade AJ, Aoki SK, Ayeni OR, Balakumar J, Bonin N, Brick MJ, Cakic JN, Domb BG, et al.
Journal: Arthroscopy, October 2022
DOI: 10.1016/j.arthro.2022.03.027
Background
Diagnosing hip instability intraoperatively is complex and inconsistent. An international panel convened to define consensus-based criteria for confirming instability during arthroscopy.
Methods
Expert panel reviewed literature and clinical practice patterns to identify potential intraoperative indicators.
A modified Delphi process and in-person consensus conference were used to finalize diagnostic criteria.
Key Findings
Eight intraoperative findings reached consensus as supportive of hip instability, including:
- Ease of hip distraction
- Specific chondral/labral damage patterns
- Observed capsular laxity or defects
- No consensus was reached on some criteria (e.g., ligamentum teres tears, certain arthroscopic instability tests).
Conclusions
A validated set of intraoperative criteria for hip instability can aid surgeons in accurate diagnosis and decision-making during hip arthroscopy.
What Does This Mean for Providers?
This expert-derived consensus provides a practical framework for intraoperative confirmation of hip instability. Incorporating these criteria may improve diagnostic precision and inform decisions regarding capsular management, particularly in borderline dysplasia or atraumatic laxity cases.