Editorial Commentary: Quantifying Patient Satisfaction After Hip Arthroscopy: I Cannot Deactivate Until You Are Satisfied With Your Care

The evolution of hip-preservation research is now streamlining toward evaluating our results as they relate to minimal clinically important difference, patient acceptable symptomatic state and substantial clinical benefit and less to P value-only significance. The keystone to successful hip-preservation procedures lies in proper patient selection, expert surgical execution, following results, and measuring satisfaction over time. Having a truly objective measure for establishing patient satisfaction is paramount to guiding surgical success.     

Editorial Commentary: Hip Joint Laxity,Microinstability, or Instability Require Precise Definition: No Matter What You Call It,It's Here to Stay!

Hip instability has gained recognition as an important cause of hip pathology. Causes include incongruency of the articular surfaces due to dysplasia and/or impingement, joint capsule pathology, labral pathology, ligamentum teres tears, ligamentous laxity, muscular imbalance, and tendon tears. Lacking clearly defined symptoms and tests has hindered identification and treatment of this condition. Furthermore, the relevant literature uses different terms such as hyperlaxity and microinstability to describe this patient population, conveying different messages. However, the different terms convey different messages. Joint hyperlaxity or hypermobility has sometimes been used in reference to the hip; however, these usually refer to a genetic ligamentous and capsular condition affecting collagen structure, such as in Ehlers Danlos Syndrome. More common, and often interchangeable, terms are instability and microinstability. As the authors state in the present study, ‘instability’ has the advantage of conveying the significant impact the condition has on a patient’s life. On the other hand, ‘microinstability’ may more accurately reflect the vague clinical presentation that we often encounter in the average hip patient with instability. Most patients do not complain of symptoms commonly seen in other joints with “instability,” such as giving way, subluxation, and recurrent dislocations. In the hip, the symptoms are generally less tangible, and hence, the term “microinstability” may be more appropriate.