Hip joint instability

Background Hip instability is a complex symptom and must be examined comprehensively and in a standardized manner. A multitude of different structures influence the guidance of the hip joint, and the dedicated analysis of the etiology is complex. Aim of work The aim of this work is to provide a comprehensive overview of hip instability. Materials and methods A comprehensive literature analysis on the subject of hip instability will be carried out by July 2024 and will be specifically reviewed according to the following key areas: hip stabilizers, examination, diagnostics, clinical pictures. Results Targeted clinical tests can indicate hip instability. However, the cause of hip instability cannot be determined purely clinically. Numerous bony parameters of the acetabulum and femur can be measured on the standardized pelvic overview radiograph. Further X-ray images should be taken for certain questions (e.g. FAI). Cross-sectional imaging using MRI allows a comprehensive assessment of the soft tissue. This makes subsequent damage to the labrum or cartilage caused by instability visible and must be correlated with the examination and symptoms. Discussion The hip joint is stabilized by bony, muscular and capsule-ligament structures, with a complex interaction of all structures involved ensuring good guidance of the hip joint. Often there are several pathologies, such as hip dysplasia with coxa valga et antetorta, which can contribute to hip instability. As a result, damage to the labrum and cartilage can occur due to a bony conflict or misalignment, which may also need to be addressed surgically.