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Effective Management Options for Treatment of Microinstability of the Hip: a Scoping Review

  • Outcomes in Research in Orthopedics (B Feeley, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the recent literature identifying and summarizing the research involving management of microinstability of the hip and highlight new and evolving techniques in its treatment.

Recent Findings

Recent updates in the understanding of capsular management hip arthroscopy will likely lead to less revision surgery and a decreased incidence of persistent post-operative pain. Repair of residual capsular defects has shown good outcomes with high patient satisfaction. Capsular plication remains the gold standard for hips with increased pain that show signs of capsular laxity/deficiency on exam or imaging. Capsular reconstruction has shown equivalent results to other revision hip arthroscopy procedures with low rates of complications. Ligamentum teres pathology, although rare, should be considered a source of pain, particularly in patients with laxity on exam. In cases where CAM over-resection has occurred, remplissage using allograft is an effective option for restoring the capsular suction seal and stability.

Summary

Microinstability is increasingly being recognized as a source of post-operative hip pain. Patients with collagen disorders remain a challenging clinical entity with increased rates of complications and post-operative pain. CAM resection should be performed carefully and not disrupt the suction seal but be sufficient to not cause further impingement. Improved evidence including well-designed prospective studies with large sample sizes will determine the future management of this complex problem.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1200 Main St West, 4E15, Hamilton, Ontario, L8N 3Z5, Canada

    Graeme Matthewson, Ali Shahabinezhad, Andrew Duong & Olufemi R. Ayeni

  2. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    Allison Williams

  3. Faculty of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland

    Matthew Macciacchera

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  1. Graeme Matthewson
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Correspondence to Olufemi R. Ayeni.

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Matthewson, G., Williams, A., Macciacchera, M. et al. Effective Management Options for Treatment of Microinstability of the Hip: a Scoping Review. Curr Rev Musculoskelet Med 16, 9–18 (2023). https://doi.org/10.1007/s12178-022-09808-w

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