Hip microinstability and its association with femoroacetabular impingement: A scoping review.
Rahel Caliesch, David Beckwée, Jan Taeymans and 4 others
PMID 39108275WHAT IT FOUND
Hip microinstability and FAI often coexist, but diagnostic criteria remain inconsistent.
Conservative care is first-line, yet high-quality evidence for its effectiveness is lacking. Surgery is reserved for failures after 3-6 months, but outcomes vary significantly between studies.
Key findings
01There is no consensus on diagnostic criteria for hip microinstability, and diagnosis relies on pattern recognition of clinical, radiological, and intraoperative signs.
02First-line treatment is conservative management, including strengthening and activity modification, but high-level studies on efficacy are lacking.
03Hip microinstability and FAI are not mutually exclusive and may coexist or aggravate each other.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The scientific rigour of the included studies was not assessed, so no grading of evidence was provided. Diagnostic criteria for microinstability are inconsistent, leading to potential under- or over-inclusion of studies. There is a lack of high-quality randomized controlled trials evaluating conservative treatment effectiveness. Most data comes from surgical populations, which may not reflect the experience of clinicians treating non-surgical patients.
Declared interests
The authors declared no conflicts of interest and no funding.
The easy way to misread this
Do not assume that strengthening exercises alone will resolve symptoms, as high-level evidence for conservative treatment efficacy is missing. Also, do not treat microinstability and FAI as mutually exclusive diagnoses, as they frequently coexist and may require different management strategies.