Pelvic Rotation in Femoroacetabular Impingement Is Decreased Compared to Other Symptomatic Hip Conditions.

Study Design Cross-sectional, case-control design. Background Pelvic movement has been considered a possible discriminating parameter associated with femoroacetabular impingement (FAI) symptom onset. Decreased pelvic rotation has been found during squatting in people with FAI when compared to people with healthy hips. However, it is possible that changes in pelvic movement may occur in other hip conditions because of pain and may not be specific to FAI. Objectives To compare sagittal pelvic rotation during hip flexion and in sitting between people with FAI and people with other symptomatic hip conditions. Methods Thirty people with symptomatic FAI, 30 people with other symptomatic hip conditions, and 20 people with healthy hips participated in the study. Sagittal pelvic rotation was calculated based on measures of pelvic alignment in standing, hip flexion to 45° and 90°, and sitting. Results There were significant differences in sagittal pelvic rotation among the 3 groups in all conditions (P<.05). Post hoc analyses revealed that participants in the symptomatic FAI group had less pelvic rotation during hip flexion to 45° and 90° compared to participants in the other symptomatic hip conditions group and the hip-healthy group (mean difference, 1.2°-1.9°). In sitting, participants in the other symptomatic hip conditions group had less posterior pelvic rotation compared to those in the hip-healthy group (mean difference, 3.9°). Conclusion People with symptomatic FAI have less posterior pelvic rotation during hip flexion when compared to people with other symptomatic hip conditions and those with healthy hips. Level of Evidence Diagnosis, level 4. J Orthop Sports Phys Ther 2016;46(11):957-964. Epub 29 Sep 2016. doi:10.2519/jospt.2016.6713.

Lesäo isolada do ligamento cruzado posterior em criança: relato de caso e revisäo da literatura / Isolated posterior cruciate ligament lesion in a child: case report and literature review

Criança do sexo masculino, com dez anos de idade, sofreu acidente com queda da garupa de uma moto, com trauma no joelho esquerdo por mecanismo nao identificado. O exame inicial mostrou sinais clínicos evidentes de lesao do ligamento cruzado posterior (LCP). Através de artroscopia, foi identificada lesao isolada do referido ligamento. Numa revisao literatura sobre o assunto, constatou-se que a lesao completa, isolada e sem arrancamento osteocartilaginoso do LCP na criança, é uma lesao rara, os tratamentos sao controversos e os resultados insatisfatórios. No caso relatado, optou-se por tratamento conservador e observaçao periódica; na revisao após 30 meses, a criança encontrava-se assintomática e participava de todas as atividades físicas e esportivas, apesar da instabilidade posterior. A apresentaçao desse caso vem ilustrar pontos importantes sobre as lesoes ligamentares do joelho na criança, a raridade dessas lesoes, as possibilidades para o diagnóstico e discussao sobre o tratamento.