RESUMO
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.
Assuntos
Artralgia/etiologia , Impacto Femoroacetabular/etiologia , Lesões do Quadril/diagnóstico , Lesões do Quadril/etiologia , Treinamento Resistido/efeitos adversos , Levantamento de Peso/lesões , Artralgia/diagnóstico , Artralgia/prevenção & controle , Terapia Combinada , Feminino , Impacto Femoroacetabular/diagnóstico , Impacto Femoroacetabular/terapia , Lesões do Quadril/terapia , Humanos , Imobilização/métodos , Exame Físico/métodos , Modalidades de Fisioterapia , Radiografia/métodos , Resultado do Tratamento , Adulto JovemRESUMO
The acetabular labrum is a complex fibrocartilaginous structure with unique anatomy. Its unique anatomy imparts biomechanical functions important in hip stability, synovial fluid dynamics, contact pressure dissipation, proprioception, and nociception. Although the importance of labral preservation through surgical repair techniques has been increasingly recognized, situations do occur where the labrum is either absent, deficient, or simply irreparable. In these situations, both open and arthroscopic reconstructive techniques have been described to help restore the function of the native labral tissue. Efforts should be made to maintain or reestablish the native structure and function of the labrum in young patients with at least 2 mm of joint space based on the available biomechanical and clinical evidence. Return to sport, significant improvements in pain and function, high levels of satisfaction, and avoidance of hip arthroplasty have been shown in patients undergoing labral reconstruction. Although short-term results of labral reconstruction are promising, long-term follow-up and comparative studies will be necessary to further define its indications and contraindications.