Approach to the Patient Evaluation Using Static and Dynamic Hip Pathomechanics

The etiology of mechanical hip pain in the absence of osteoarthritic changes requires a careful consideration of static and dynamic factors. Dynamic factors result from abnormal stress and contact between the femoral head and acetabular rim with hip motion, whereas static factors result from asymmetric and supraphysiologic loads between the femoral head and acetabular socket when in the standing or axially loaded position. Compensatory motion resulting from restricted terminal hip motion may adversely affect dynamic muscle forces across the hip joint, leading to several other related extra-articular symptoms and pain. An appreciation of abnormal hip morphology and hip joint mechanics is required to understand the important role of both static and dynamic stresses in the development of hip pain and early onset osteoarthritis in the young hip. This review describes the static and dynamic factors associated with mechanical hip pain to allow for the development of a thoughtful and effective treatment plan.