Microinstability of the hip- a previously unrecognized pathology Commentary
Hip microinstability is an established diagnosis that involves small, extra-physiologic hip motions that causes pain with or without symptoms of hip joint instability. However, its occurrence is still debated by many physicians as no objective criteria has been proposed to characterize hip microinstability. Additionally, diagnosis of hip microinstability is often challenging, due to a lack of specific signs or symptoms, and patients may remain undiagnosed for long periods. This may lead to early manifestation of degenerative joint disease. The purpose of this review article was to elucidate diagnostic criteria and provide a treatment approach to manage microinstability in the hip.
In brief, conservative treatment is considered the best initial approach, though, surgical intervention should be considered if symptoms (such as pain and giving-away) persist or other hip pathology exists. Successful surgical intervention, if needed, should focus on restoring the normal anatomy of the hip joint in order to regain its functionality. This is important as the anatomical integrity of the soft tissues together with their elastic properties, contribute greatly to the stabilization properties of the hip joint. If not managed correctly, patients may become predisposed to instability problems and severe osteoarthritis of the hip. Therefore, a patient-specific, comprehensive rehabilitation program is vital to achieve successful long-term outcomes.