N°009 - Juanary / February 2021
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Microinstability of the hip: a new concept to explain unclear hip and groin pain
By Frédéric Laude in category UPDATE
Clinique du sport Paris. 36 boulevard Saint-Marcel / 75005 Paris [email protected]
Symptomatic hip microinstability is very often not diagnosed. It has been identified recently as a potential cause of chronic pain and disability. Clinical and imaging diagnosis is helpful to identify this new pathology. Non-surgical management should be the first choice and surgical intervention might be considered in patients with persistent pain.
For the past twenty years or so, hip specialists have been studying the concept of femoroacetabular impingement. This has improved their understanding of the pathogenesis of osteoarthritis of the hip, and some cases are now even suitable for surgical correction (1-4). However, even if there is a lack of any radiograph findings, not all incidences of hip pain are due to impingement. Influenced by the two American surgeons Marc Safran (5, 6) and Marc Philippon (7), we are beginning to better understand the concept of microinstability and new treatments are being developed, both conservative and arthroscopic. Hip instability is a somewhat vague term. The hip obviously obtains much of its natural stability from the skeletal anatomy, with a femoral head designed to sit neatly inside the bony acetabulum, but the adjacent soft tissues also contribute to the stability. The acetabular labrum and the up to a centimetre thick...
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