Understanding of the etiology and pathology of hip instability has increased in recent years as new information has emerged regarding the disease processes of the hip. Hip instability, heretofore considered uncommon in clinical practice, is increasingly recognized as a pathologic entity. Instability may be classified as traumatic or atraumatic, and diagnosis is made based on patient history, physical examination, and imaging studies. Plain radiography, MRI, MRI arthrography, and hip instability tests (eg, posterior impingement, dial) can be used to confirm the presence of instability. Nonsurgical management options include physical therapy and protected weight bearing. Surgical intervention, whether arthroscopic or open, is required for large acetabular fractures and refractory instability. Knowledge of the etiology and evolving research of hip instability is essential to understand the spectrum of hip disease.
From the Department of Orthopaedic Surgery, Division of Sports Medicine, Children's Hospital Boston, Boston, MA (Dr. Boykin and Dr. Kocher), the Department of Orthopaedic Surgery, Wake Forest University Baptist Medical Center, Winston-Salem, NC (Dr. Anz and Dr. Stubbs), Harbin Clinic, Orthopaedics and Sports Medicine, Rome, GA (Dr. Bushnell), and the Steadman Philippon Research Institute, Vail, CO (Dr. Philippon).
Dr. Kocher or an immediate family member serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, the Anterior Cruciate Ligament Study Group, the American Orthopaedic Society for Sports Medicine, the Herodicus Society, the Pediatric Orthopaedic Society of North America, and the Steadman Philippon Research Institute; has received royalties from Biomet; serves as a paid consultant to or is an employee of Biomet, OrthoPediatrics, Pediped, and Smith & Nephew; has stock or stock options held in Fixes-4-Kids and Pivot Medical; and serves on the editorial or governing board of the Journal of Bone and Joint Surgery American and the Journal of Shoulder and Elbow Surgery. Dr. Stubbs or an immediate family member serves as a board member, owner, officer, or committee member of the International Society for Hip Arthroscopy and the American Orthopaedic Society for Sports Medicine; serves as a paid consultant to or is an employee of Smith & Nephew and Johnson & Johnson; has stock or stock options held in Johnson & Johnson; and serves on the editorial or governing board of VuMedi. Dr. Philippon or an immediate family member serves as a board member, owner, officer, or committee member of the International Society for Hip Arthroscopy and the Steadman Philippon Research Institute; has received royalties from Smith & Nephew, Bledsoe, Arthrosurface, and DonJoy; is a member of a speakers' bureau or has made paid presentations on behalf of and serves as a paid consultant to or is an employee of Smith & Nephew; has received research or institutional support from Össur, Arthrex, Saucony, OrthoRehab, Opedix, Siemens, and the Steadman Philippon Research Institute; has stock or stock options held in Smith & Nephew, Arthrosurface, Hipco, and MIS; and has received nonincome support (such as equipment or services), commercially derived honoraria, or other non-research-related funding (such as paid travel) from Smith & Nephew. None of the following authors or any immediate family member has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Boykin, Dr. Anz, and Dr. Bushnell.
J Am Acad Orthop Surg 2011; 19: 340–349
