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Cited by 100Hip disorders and treatmentsLower Extremity Biomechanics and PathologiesPelvic and Acetabular Injuries

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Microinstability of the hip: A review

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Dangin, A., Tardy, N., Wettstein, M., May, O., Bonin, N.·2016·Orthopaedics & Traumatology: Surgery & Research
DOI 10.1016/j.otsr.2016.09.002
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Abstract

With the development of conservative hip surgery techniques, new entities such as microinstability have been identified. Microinstability is a painful supra-physiological mobility of the hip. It results from the association of architectural and functional abnormalities impairing joint stability. These risk factors concern hip joint bone architecture or peri-articular soft tissues. Bone abnormalities are identified on hip assessment parameters. Soft tissues also play a key role in the static and dynamic stability of the hip: the joint capsule, labrum, ligamentum teres and adjacent myotendinous structures affect joint coaptation; any abnormality or iatrogenic lesion concerning these structures may constitute a risk factor for microinstability. Diagnosis is based on interview, clinical examination and imaging. Findings of labral lesions or femoro-acetabular impingement do not rule out microinstability; they may be associated. Treatment is based first on physiotherapy for muscle reinforcement to improve joint coaptation. In case of failure, arthroscopic surgery is indicated for femoro-acetabular impingement and capsular plicature which is being evaluated. Periacetabular osteotomy or shelf acetabuloplasty may be indicated, according to the severity of joint bone architecture abnormality. Microinstability is a multifactorial entity. Lesions induced by microinstability may in turn become risk factors for aggravation. Diagnosis and indications for surgery are thus difficult to establish. Only full clinical examination and exhaustive imaging assessment allow microinstability and associated lesions to be identified.

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Metadata

Authors
Dangin, A., Tardy, N., Wettstein, M., May, O., & Bonin, N.
Affiliations
Clinique de Genolier (CH)
Corresponding author
Dangin, A.
ORCID
Venue
Orthopaedics & Traumatology: Surgery & Research
Publisher
Elsevier BV
Published
2016-12
Volume
102
Issue
8
Pages
S301-S309
ISSN
1877-0568 (ISSN-L)
DOI
10.1016/j.otsr.2016.09.002
OpenAlex
W2530008805
Cited by
100
References
0
Citations by year
2026: 10 · 2025: 8 · 2024: 16 · 2023: 8 · 2022: 14 · 2021: 15 · 2020: 14 · 2019: 10 · 2018: 5
FWCI
0.99
Type
journal article
Language
en
Open access
Licence
Locations
  • Orthopaedics & Traumatology Surgery & Research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Hip disorders and treatments
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
  • Health Sciences › Medicine › Surgery › Pelvic and Acetabular Injuries
Keywords
hip microinstability, hip stability, femoroacetabular impingement, labral lesions, joint capsule, ligamentum teres, periacetabular osteotomy, arthroscopic surgery, physiotherapy
MeSH terms
Hip Joint, Humans, Joint Instability, Ligaments, Articular, Risk Factors, Muscle, Skeletal, Orthopedic Procedures, Physical Therapy Modalities, Fibrocartilage, Femoracetabular Impingement

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