Displasia acetabular limítrofe dolorosa: O que há de novo?

A displasia do desenvolvimento do quadril (DDQ), é uma patologia estática-dinâmica complexa que conduz à instabilidade articular crônica e à artrose. Já a displasia acetabular borderline (limítrofe) refere-se a padrões levemente anormais na forma e na cobertura acetabular que não estão dentro dos valores para serem considerados displásicos. Entretanto, tais padrões podem predispor a disfunção mecânica e instabilidade quadril. O diagnóstico e o tratamento continuam sendo um tópico controverso na preservação do quadril, com pouca literatura comparativa atual para orientar o diagnóstico preciso e a tomada de decisão do tratamento. Historicamente o diagnóstico da DDQ limítrofe foi baseado em avaliações da anatomia acetabular na radiografia pélvica anteroposterior, mais comumente o ângulo da borda central lateral (LCEA), com valores normais entre 20 e 25°, ou, em alguns estudos mais recentes, 18 a 25°. Quanto a tomada de decisão de tratamento em casos cirúrgicos, há grande debate entre a utilização artroscopia isolada do quadril ou osteotomia periacetabular, tendo em vista que diagnóstico mecânico fundamental (instabilidade versus impacto femoroacetabular) pode ser difícil de determinar nos casos de DDQ limítrofe. Assim, para uma tomada de decisão cirúrgica efetiva, a avaliação de características adicionais da anatomia óssea, instabilidade e características dos pacientes é fundamental.

Palavras-chave

articulação do quadril - diagnóstico por imagem - impacto femoroacetabular - luxação do quadril - tomada de decisões

Bibliographical Record
Rodrigo Monari, Fábio Lima Ferreira Pessiquelli, Eduardo Gomes Machado. Displasia acetabular limítrofe dolorosa: O que há de novo?. Rev Bras Ortop (Sao Paulo) 2025; 60: s00441790212.
DOI: 10.1055/s-0044-1790212

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References

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