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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2023

20-04-2022 | HIP

Hip microinstability diagnosis and management: a systematic review

Authors: Dan Cohen, Pierre-Olivier Jean, Milin Patel, Neveadan Aravinthan, Nicole Simunovic, Andrew Duong, Marc R. Safran, Vikas Khanduja, Olufemi R. Ayeni

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2023

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Abstract

Purpose

The purpose of this systematic review is to present the most common causes, diagnostic features, treatment options and outcomes of patients with hip micro-instability.

Methods

Three online databases (MEDLINE, Embase, and PubMed) were searched from database inception March 2022, for literature addressing the diagnosis and management of patients with hip micro-instability. Given the lack of consistent reporting of patient outcomes across studies, the results are presented in a descriptive summary fashion.

Results

Overall, there were a total of 9 studies including 189 patients (193 hips) included in this review of which 89% were female. All studies were level IV evidence with a mean MINORS score of 12 (range: 10–13). The most commonly used features for diagnosis of micro-instability on history were anterior pain in 146 (78%) patients and a subjective feeling of instability with gait in 143 (81%) patients, while the most common feature on physical examination was the presence of anterior apprehension with combined hip extension and external rotation in 123 (65%) patients. The most common causes of micro-instability were iatrogenic instability secondary to either capsular insufficiency or cam over-resection in 76 (62%) patients and soft tissue laxity in 38 (31%) patients.

Conclusion

The most common symptom of micro-instability on history was anterior hip pain and on physical exam was pain with hip extension and external rotation. There are many treatment options and when managed appropriately based on the precise cause of micro-instability, patients may demonstrate improved outcomes.

Level of evidence

IV.
Appendix
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Metadata
Title
Hip microinstability diagnosis and management: a systematic review
Authors
Dan Cohen
Pierre-Olivier Jean
Milin Patel
Neveadan Aravinthan
Nicole Simunovic
Andrew Duong
Marc R. Safran
Vikas Khanduja
Olufemi R. Ayeni
Publication date
20-04-2022
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-022-06976-7

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