Hip Instability

There are 3 main factors that determine the stability of the hip.

  1. Bony anatomy is the most important factor that contributes to the stability.
  2. The Labrum contributes to the stability because of the suction seal effect and the creation of a negative pressure in the joint. The space between the femoral head (ball) and acetabulum (socket) is sealed of by this structure.
  3. Ligaments of the hip capsule

The symptoms of instability are giving away, laxity, of the hip and clicking. Injury to any of the above mentioned structures can cause instability. The hip conditions that can give symptoms of instability are labral tears, hip dysplasia, femoro acetabular impingement, focal rotational instability and ligamentum teres tears.

In the majority of the cases, the surgeon should be able to find the correct cause for the instability with history taking, clinical examination and standard X rays.

Treatment of the instability depends on the cause. Currently, incomplete bony coverage of the femoral head (ball) cannot be corrected with arthroscopy. A laxity of the anterior hip capsule, however, can be corrected efficiently. This type of instability is commonly seen in sports. In sports with rotation such as soccer, cricket, ice hockey, tennis and throwing sports, the ligament of the anterior hip capsule (Ilio femoral ligament) can stretch out causing a focal rotational type of instability. This type of instability can cause labral tears in which case the instability also becomes associated with pain.


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