目的：髋关节微不稳定性是一种相对较新的诊断方法，文献中对此进行了越来越多的讨论，但尚无明确的诊断指南。微不稳定性通常被定义为持续的过度髋关节运动，尤其是疼痛的症状。这项Delphi研究的目的是寻求专家意见，以制定髋关节微不稳定性的诊断标准。
方法：本共识研究采用德尔菲法。截至2019年3月，在PubMed上使用关键词（（臀部）和（微不稳定性））进行了文献检索，以确定有关该主题的相关文章。对用于诊断髋关节微不稳定性的所有相关标准进行了整理，以创建问卷，并包括了专家建议的进一步标准。通过在线调查平台进行了四轮问卷调查。在每一轮之间，作者充当管理中间人，向专家提供结果摘要，并综合下一份问卷。专家小组由27名成员组成：来自世界各地的24名（89％）整形外科医生和3名（11％）物理治疗师。
结果：专家小组参与第1-4轮为：27（100％），20（74%），21(78%)和26(96%)。作者的文献综述确定了32项诊断标准来填充第一份问卷。专家建议修改三个标准并创建五个新标准。小组将排名第三(8%)的标准归为“不重要”，20（54%）作为“次要因素”，14（38%）作为“主要因素”。没有标准被列为“基本”。标准被细分为患者病史，检查和成像。专家投票通过了每个子类别中四个标准的最低要求，包括至少六个“主要因素”。最终的诊断工具被最终圆形面板的20个(77%)批准。
结论：本研究描述了关于诊断髋关节微不稳定的第一个已知专家共识。最终诊断工具的相对复杂性说明了临床医生在进行诊断时面临的困难。
方法：V.
OBJECTIVE: 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.
METHODS: 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 members: 24 (89%) orthopaedic surgeons and 3 (11%) physiotherapists from around the world.
RESULTS: Expert panel participation in rounds 1-4 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 \"Not important\", 20 (54%) as \"Minor Factors\" and 14 (38%) as \"Major Factors\". No criteria was ranked as \"Essential\". 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 \"Major factors\". The final diagnostic tool was approved by 20 (77%) of the final round panel.
CONCLUSIONS: 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\' face when making this diagnosis.
METHODS: V.
