Hip Tendinopathies: An Update of Concepts and Approaches / Tendinopatias do quadril: Uma atualização de conceitos e abordagens

Abstract The present update was based on new scientific evidence of major hip-related tendinopathies. Themes were addressed that involve the principles of the onset of tendinopathies through, mainly, the principle of capacity versus demand and the biomechanical aspects involved in its onset, its main characteristics, and clinical presentations. Associated with this, treatment-related updates were presented, with exercise therapy being the focus of conservative treatment and surgical approaches necessary for the control or resolution of these cases.

Resumo A presente atualização foi embasada nas novas evidências científicas das principais tendinopatias relacionadas ao quadril. Foram abordadas temáticas que envolvem os princípios do aparecimento das tendinopatias através, principalmente, do princípio da capacidade versus demanda e os aspectos biomecânicos envolvidos no seu aparecimento, suas principais características e apresentações clínicas. Associadas a isso, foram expostas as atualizações voltadas ao tratamento, coma terapia por exercício sendo o foco do tratamento conservador e as abordagens cirúrgicas necessárias para o controle ou resolução desses casos.

Subspine Hip Impingement: An Unusual Cause of Hip Pain in an Elite Weightlifter.

Anterior hip pain can be difficult to diagnose due to the many pathologies and overlapping pain patterns that exist in the hip region. Clinical findings of pain at the anterior inferior iliac spine with passive hip flexion, proximal quadriceps pain and weakness, and painful impingement tests of the hip may be indicative of subspine hip impingement. This report describes the diagnosis and treatment of anterior hip pain, including subspine impingement and femoroacetabular impingement in an elite weightlifter. This case also describes how with the correct diagnosis and treatment, the athlete returned to play to her previous level of sport 11 months after a complex hip injury.

Hip Pain in Athletes - When It is Not the Labrum.

Hip pain is a relatively common complaint in sports. It is tempting to blame the athlete's symptoms on labral pathology. However, there is a high incidence of asymptomatic labral disease. Therefore, even when a labral tear is present, it may not be the underlying cause of the patient's pain. Clinicians should familiarize themselves with the large differential diagnosis for hip and pelvis pain to include nonmusculoskeletal pathology. This article reviews nonlabral causes of hip pain in athletes. For ease of classification, the hip is divided into anterior, lateral, and posterior regions.

Tratamento artroscópico de lesões do quadril em 35 atletas / Arthroscopic treatment of hip pathology in 35 athletes

Introdução: A artroscopia do quadril ganhou espaço recentemente como parte do instrumental no tratamento de afecções do quadril no atleta. Objetivo: Apresentar o resultado de 35 artroscopias realizadas em atletas federados. Métodos: Análise retrospectiva do prontuário de pacientes. Resultados: Durante o procedimento cirúrgico 31 pacientes apresentaram como diagnóstico impacto femoroacetabular e lesão do lábio acetabular. Duas complicações ocorreram uma neuropraxia do nervo pudendo e uma úlcera escrotal. Após um seguimento médio de 2,8 anos o Western Ontario and MacMacter Universities Osteoarthritis Index (WOMAC) melhorou de uma média de 68,4 pré-operatória para uma média de 89,5 pós-operatória. Conclusão: A artroscopia do quadril é uma cirurgia com bons resultados em atletas com dor no quadril.

Nonsurgical treatment of acetabular labrum tears: a case series.

STUDY DESIGN: Case series. BACKGROUND: While the literature has emphasized surgical treatment of acetabular labrum tears, there is a lack of information regarding conservative treatment. The purpose of this case series was to describe a nonsurgical program for those with clinical evidence of an acetabular labrum tear, that emphasized hip and lumbopelvic stabilization, correction of hip muscle imbalance, biomechanical control, and sport-specific functional progression. CASE DESCRIPTION: The 4 patients in this series had clinical evidence and magnetic resonance imaging confirmation of an acetabular labrum tear and underwent a similar treatment protocol consisting of 3 phases. Phase 1 emphasized pain control, education in trunk stabilization, and correction of abnormal joint movement. Phase 2 focused on muscular strengthening, recovery of normal range of motion (ROM), and initiation of sensory motor training. And phase 3 emphasized advanced sensory motor training, with sport-specific functional progression. ROM, flexibility, pain, special tests, and level of function were assessed, and strength was measured with handheld dynamometry. OUTCOMES: All patients demonstrated decreased pain, functional improvement, and correction of muscular imbalance. Increased muscle strength, primarily for the hip flexors (1%-39%), abductors (18%-56%), and extensors (68%-139%) was also noted. DISCUSSION: All patients responded well to our program. This case series suggests that patients with clinical evidence of an acetabular labral tear confirmed with MRI can show meaningful improvement with nonsurgical intervention. LEVEL OF EVIDENCE: Therapy, level 4.

Displasia do desenvolvimento do quadril / Developmental dysplasia of the hip

Os autores se propõem neste artigo a realizar uma revisão acerca do tema displasia do desenvolvimento do quadril abordando: fisiopatologia , manifestações clinicas,diagnóstico e tratamento.

Sinovitis transitoria de cadera / Transient synovitis of the hip

Patología inflamatoria aguda, también llamada cadera irritable o sinovitis tóxica, es la principal causa de dolor en la cadera de los niños. Se indica cómo realizar la ecografía para un correcto diagnóstico.

Tratamiento artroscópico del pinzamiento femoroacetabular: reporte de casos y revisión de la literatura / Arthroscopic treatment of hip labrum impingement: case series: [review]

El pinzamiento femoroacetabular puede ser un factor importante pero sutil en el desarrollo de cambios degenerativos de la cadera. El pinzamiento mecánico de la cadera puede originarse bien sea por una relación anormal de la unión anterior entre la cabeza y el cuello femoral o por una morfología acetabular anormal. La artrorresonancia magnética es una herramienta poderosa para evaluar estas causas óseas de pinzamiento femoroacetabular y de las lesiones asociadas del labrum y del cartílago. El reconocimiento temprano y el tratamiento apropiado de la causa de esta patología pueden retardar la progresión hacia una enfermedad degenerativa de la cadera, particularmente en pacientes jóvenes. En este artículo se hace una revisión de las publicaciones existentes sobre el tema y un reporte de nuestra experiencia en pacientes con pinzamiento femoroacetabular evidente. Aunque son pocos casos y con un seguimiento corto, se trata de un aporte para hacer énfasis en reconocer y tratar precozmente esta patología y probablemente evitar o retardar la presencia de osteoartritis degenerativa en nuestro medio.