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Traumatic Instability: Acute and Delayed Management

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Sports-related traumatic instability of the hip is generally the result of a low velocity mechanism compared to vehicular trauma. Most are posteriorly directed because of the typical mechanisms of injury. Anterior instability is less common and more frequently associated with atraumatic instability. Femoroacetabular impingement (FAI) morphology can create a fulcrum, placing the joint at a mechanical disadvantage and making it more susceptible to posterior instability. Following traumatic subluxations, the symptoms are sometimes not severely disabling and may belie the magnitude of injury. Thus, it is important to be keen in interpreting radiographs when looking for posterior rim fractures and performing appropriate diagnostic studies when there is an index of suspicion.

Most cases of traumatic instability can be treated conservatively with a high likelihood of returning to athletic endeavors. The presence of entrapped fragments, a non-concentric reduction, or recurrent instability may force early surgical intervention. For cases treated conservatively, three or four months may be necessary for resolution of the acute injury phase. By then, if mechanical symptoms persist, this may indicate a role for arthroscopy. Standardized methodologies have been developed for the management of these injuries.

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Author information

Authors and Affiliations

  1. Nashville Sports Medicine Foundation, Nashville, TN, USA

    J. W. Thomas Byrd

  2. Methodist Sports Medicine, Indianapolis, IN, USA

    G. Peter Maiers II

Authors
  1. J. W. Thomas Byrd
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  2. G. Peter Maiers II
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Corresponding author

Correspondence to J. W. Thomas Byrd .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi

  3. Department of Orthopaedic Surgery, Joint Preservation and Cartilage Restoration Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Center for Hip Preservation Surgery Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Premier Hip Arthroscopy, Marina del Rey, CA, USA

    Dean K. Matsuda

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Byrd, J.W.T., Peter Maiers, G. (2022). Traumatic Instability: Acute and Delayed Management. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_81

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  • DOI: https://doi.org/10.1007/978-3-030-43240-9_81

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-43239-3

  • Online ISBN: 978-3-030-43240-9

  • eBook Packages: MedicineReference Module Medicine

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