Atraumatic Hip Instability in Patients With Joint Hypermobility

Atraumatic hip instability is a recently described source of hip pain and disability. Hip instability may be caused by bony dysplasia, benign or inherited joint hypermobility syndromes, or iatrogenic damage to the hip capsule during arthroscopy. A thorough understanding of hip capsular anatomy is essential to the management of instability, and is reviewed in this study. In addition, the essential historical, clinical, and radiographic findings of atraumatic hip instability are presented. Critical concepts include early referral in the presence of inherited joint hypermobility syndromes, the use of validated criteria for detection of benign joint hypermobility, and systematic efforts to understand the cause of instability before initiating treatment. Although nonoperative measures can successfully treat atraumatic hip instability, surgical intervention is often warranted, and the technical principles of hip capsular plication are described in detail.