{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:06:43Z","timestamp":1793117203839,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T00:00:00Z","timestamp":1651276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T00:00:00Z","timestamp":1651276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,4,30]],"date-time":"2022-04-30T00:00:00Z","timestamp":1651276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Hip microinstability is a relatively new diagnosis which is increasingly being discussed in the literature and yet there are no clear guidelines for making a diagnosis. Microinstability has generally been defined as persistent excessive hip motion that has become symptomatic especially with pain. This aim of this Delphi study was to seek expert opinion to formulate a diagnostic criteria for hip microinstability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A Delphi methodology was used for this consensus study. A literature search was conducted on PubMed up to March 2019 using the keywords ((hip) and (microinstability)) to identify relevant articles on this topic. All relevant criteria used for diagnosing hip microinstability were collated to create a questionnaire and further criterion suggested by the experts were included as well. Four rounds of questionnaires were delivered via an online survey platform. Between each round the authors acted as administrating intermediaries, providing the experts with a summary of results and synthesising the next questionnaire. The expert panel was comprised of 27\u00a0members: 24 (89%) orthopaedic surgeons and 3 (11%) physiotherapists from around the world.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Expert panel participation in rounds 1\u20134 was: 27 (100%), 20 (74%), 21 (78%) and 26 (96%) respectively. A literature review by the authors identified 32 diagnostic criteria to populate the first questionnaire. Experts suggested amending three criteria and creating five new criteria. The panel converged on ranking 3 (8%) of criteria as \u201cNot important\u201d, 20 (54%) as \u201cMinor Factors\u201d and 14 (38%) as \u201cMajor Factors\u201d. No criteria was ranked as \u201cEssential\u201d. Criteria were subcategorised into patient history, examination and imaging. Experts voted for a minimum requirement of four criteria in each subcategory, including at least six \u201cMajor factors\u201d. The final diagnostic tool was approved by 20 (77%) of the final round panel.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study describes the first known expert consensus on diagnosing hip microinstability. The relative complexity of the final diagnostic tool is illustrative of the difficulty clinicians\u2019 face when making this diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>V.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-06933-4","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T10:13:43Z","timestamp":1651486423000},"page":"40-49","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Diagnosing Hip Microinstability: an international consensus study using the Delphi methodology"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9454-3978","authenticated-orcid":false,"given":"Vikas","family":"Khanduja","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Young Adult Hip Service, Addenbrooke\u2019s Cambridge University Hospital NHS Foundation Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Darby","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Young Adult Hip Service, Addenbrooke\u2019s Cambridge University Hospital NHS Foundation Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"O\u2019Donnell","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> St Vincent\u2019s Private Hospital East Melbourne East Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bonin","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Lyon Ortho Clinic Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R.","family":"Safran","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Division of Sports Medicine, Department of Orthopaedic Surgery, Team Physician Stanford University Redwood City CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The International Microinstability Expert Panel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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VK: educational consultant for Smith & Nephew and Arthrex, Chair - ESSKA Hip Arthroscopy Committee, President - British Hip Society. NB: reports personal fees from Dedeinne Sante, Stryker and CONMED outside of submitted work. JO\u2019D: nothing to disclose. MS: nothing to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Ethical approval was not needed for this study as no patients were involved and all survery findings were anonymised. All participants in the expert panel are acknowledge as contributors in this manuscript as this is a Delphi study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}