Hip Instability
Hip instability is a condition where the hip joint becomes unstable, leading to symptoms such as pain, laxity, sensations of the hip “coming out” of the socket, clicking sounds, subluxation, and dislocation. The hip joint is a ball-and-socket structure formed by the femur (thighbone) and acetabulum (hip bone), with stability provided by the labrum, ligaments, and surrounding muscles.
Causes of Hip Instability
Hip instability can be traumatic, resulting from sports injuries or motor vehicle accidents, or atraumatic, due to overuse or developmental/congenital abnormalities. Common causes include:
- Labral and ligament tears
- Hip dysplasia (undercoverage of the acetabular socket)
- Femoroacetabular impingement (FAI, abnormally shaped bones of the hip joint)
- Tears to the ligamentum teres
- Structural bony abnormalities
- Connective tissue disorders resulting in ligamentous laxity.
Hip Instability Diagnosis
Diagnosis involves a detailed medical history, physical examination, and imaging studies such as X-rays, CT scans, MRI, and MR Arthrogram scans. Special physical exam tests for instability, such as posterior impingement tests and dial tests, may also be performed.
Treatment Options for Hip Instability
Initial treatment typically includes conservative measures such as protected weight bearing, physical therapy for muscle strengthening and range of motion exercises, activity modification, and anti-inflammatory medications. If conservative treatment fails, surgical options include hip arthroscopy (to repair or tighten the hip capsule and repair any damaged structures) or open surgery (such as a PAO to address hip dysplasia).
Hip instability is a multifactorial condition that can significantly impact mobility and quality of life. It requires a comprehensive approach to diagnosis and treatment, with both conservative and surgical options available depending on the severity and underlying causes of the instability.
