Clues to the diagnosis of hip microinstability is still evolving. We hypothesized that hip range of motion (ROM) will be greater in patients with hip microinstability than in patients with femoroacetabular impingement (FAI) alone.

Methods

After IRB approval, a retrospective chart review was performed for patients undergoing arthroscopic surgery for hip microinstability (thus arthroscopically confirmed microinstability) and FAI at an academic center. A power analysis determined 25 patients were needed in each group to detect a 5 degree difference. After adjusting for gender, BMI, age, and smoking status, multivariable generalized linear models were used to detect differences. Sensitivity and specificity were determined for multiple flexion plus rotation arc measures. Finally, a logistic regression was used to create a model to determine the probability of microinstability with a given gender, BMI, age and degree of flexion. Microinstability was defined as any patient requiring capsular plication for instability based on previously published intra-operative parameters at our institution. FAI was defined as alpha angle >55 degrees, center edge angle >35 degrees, or other radiographic parameter of pincer impingement, such as crossing sign. ROM including hip flexion, internal rotation, external rotation and rotation arc were recorded in degrees.

Results

Seventy five patients were included in this study: 25 with isolated hip microinstability, 25 with isolated FAI, and 25 patients had combined microinstability with FAI (CM-FAI). No difference in ROM was found between microinstability and CM-FAI groups for all ROM parameters. However, the isolated microinstability and CM-FAI groups had significantly greater hip flexion (128°, 135°) than FAI only (113°, p=0.003, p<0.001). Isolated hip microinstability and CM-FAI groups also had significantly greater flexion plus rotation (218°, 224°), than FAI only (180°, p=0.015, p=0.004). Flexion plus internal rotation was greater in the isolated microinstability and CM-FAI groups (162°, 168°) than in FAI only (131°, p=0.005, p<0.001). CM-FAI had a greater flexion plus external rotation (190°) than FAI only (162°, p=0.012). Rotational parameters alone showed no difference between instability and FAI groups in isolation. When flexion plus rotation arc was greater than 197.5 degrees, there was an 84% sensitivity and 76% specificity that a component of instability present. Furthermore, a risk of instability profile may be built using hip flexion, BMI, age and gender determine the probability of instability.

Conclusions

Hip microinstability is associated with a significant increase in multiple ROM parameters, even in the presence of FAI. Flexion was the most important parameter. An in-office calculation of flexion plus rotation arc greater than 197.5 degrees can be used to suggest the potential of hip microinstability as a component hip pain. Finally, flexion, BMI, age, and gender can be combined to determine the probability of hip microinstability and potentially predict the need for capsular plication.

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Characterizing the Incidence of Avascular Necrosis after Corticosteroid Injections of the Hip Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Ahab Chopra, BA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Psychologically Distressed Patients Can Obtain Meaningful Clinical Benefit from Arthroscopic Hip Surgery ePoster Presentation Benjamin Saks, MD, UNITED STATES Rachel Glein, BS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Andrew Jimenez, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Capsular Complications And Subsequent Instability On The Rise As Indications For Revision Hip Arthroscopy ePoster Presentation Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Cort D. Lawton, MD, UNITED STATES Matthew S. Dooley, MA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Traumatic Hip Dislocations In The Pediatric Patient: Injury Patterns, Need For Axial Imaging, Outcomes, And Selective Hip Arthroscopy Abstract Presentation 5 minutes Cliff Willimon, MD, UNITED STATES Anthony Egger, MD, UNITED STATES Crystal A. Perkins, MD, UNITED STATES
Utilizing Laser Doppler Flowmetry To Measure Labral Blood Flow During Arthroscopic Acetabular Labral Repair Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Mark R. Nazal, MPH, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Cleft Sign and Bone Marrow Edema of the Pubic Synthesis are Associated with Sports Activity and Bony Morphology Related to Femoroacetabular Impingement in Symptomatic Patients with Labral Tears: A Cohort Study Abstract Presentation 5 minutes Keisuke Nakayama, MD, PhD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Soshi Uchida, MD, PhD, JAPAN
Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Health Literacy in Hip Arthroscopy: A Quantitative Assessment of the Understandability and Readability of Online Patient Education ePoster Presentation Alan Shamrock, MD, UNITED STATES Burke Gao, MD, UNITED STATES Olivia O'Reilly, MD, UNITED STATES Mary Kate Skalitzky, BA, UNITED STATES Trevor Gulbrandsen, MD, UNITED STATES Michael C. Willey, MD, UNITED STATES Robert W. Westermann, MD, UNITED STATES
Snapping Hip Syndrome : An Uncommon Cause of Hip Pain ePoster Presentation Pollyanna Christine Ferreira Frazão, MD, PORTUGAL Rui Cardoso, MD, PORTUGAL Daniela Roque, MD, PORTUGAL Diogo Rocha Carvalho, Md, MsD, PORTUGAL André Santos, MD, PORTUGAL Sérgio Pita, MD, PORTUGAL Filipe Sá Malheiro, MD, PORTUGAL Tiago Pato, PORTUGAL Carlos Filipe Gonçalves João, MD, PORTUGAL Carlos Almeida, PORTUGAL
Is Arthroscopy An Adequate Therapy For All Borderline Dysplastic Hips? Correlation Between Radiologic Findings And Clinical Outcomes Abstract Presentation 6 minutes Alexander Zimmerer, MD, GERMANY Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY
Does MRI Scan Enable Optimally Informed Pre-Operative Planning In Hip Arthroscopy? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Fadi Hindi, BM, MRCS, UNITED KINGDOM Andrew Langdown, BSc MB ChB FRCS(Tr&Orth), UNITED KINGDOM
Natural History Of Femoroacetabular Impingement: Using Machine Learning To Evaluate Risk Factors For Osteoarthritis In A Large Geographic Population Over The Long-Term Abstract Presentation 5 minutes Ayoosh Pareek, MD, UNITED STATES Sunho Ko, MD, KOREA, NORTH Heath Melugin, MD, UNITED STATES Changwung Jo, MD, KOREA, REPUBLIC OF Ryan R Wilbur, BS, UNITED STATES Bryant M. Song, MS, UNITED STATES Aaron J. Krych, MD, UNITED STATES
A Systematic Review Of Terminology, Surgical Techniques, Preoperative Diagnostic Measures, And Geographic Differences In The Treatment Of Athletic Pubalgia/Sports Hernia/Core Muscle Injury/Inguinal Disruption ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES John W. Belk, BA, UNITED STATES Christopher M. Larson, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, UNITED STATES

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