¨A síndrome da dor patelofemural (SDPF) é considerada um dos acometimentos mais frequentes no joelho e sua etiologia não está bem estabelecida, porém demonstra estar relacionada a causas multifatoriais, dificultando a caracterização dos indivíduos com SDPF. Ela é definida como a presença de dor anterior no joelho ou retropatelar, principal característica da síndrome, associada a atividades que aumentem o stress na articulação patelofemural (APF), como agachamento ou subir e descer degraus. Apesar de sinais e sintomas característicos, como a presença de dor ao movimento do joelho, dor à palpação e alteração de mobilidade patelar, alteração do ângulo Q entre outras alterações estruturais, estes sinais e sintomas avaliados de maneira isolada têm-se mostrado inconsistentes quanto à diferenciação de pacientes com e sem SDPF. Basear a avaliação em alterações estruturais e de cinemática, como o movimento anormal de tíbia e fêmur nos planos transverso e frontal, fraqueza dos músculos estabilizadores do quadril e diminuição da rotação femoral, é utilizado, pois possui evidência científica, visto que é descrito na literatura que estas alterações podem levar à dor patelofemural. Alguns estudos apontam que a má-distribuição das forças de reação ao solo devido alterações no tornozelo e pé, como pronaçãosubtalar excessiva, torção tibial externa, podem desencadear disfunções patelofemurais. A avaliação funcional de indivíduos com queixa de dor anterior no joelho deve ser constituída de um questionário de dor anterior no joelho e um conjunto de sinais e sintomas que avaliem todo o membro inferior estaticamente e durante situações funcionais. O diagnóstico correto requer um conhecimento aprofundado da anatomia, biomecância e comportamento funcional da articulação femoro-patelar. O tratamento conservador é o tratamento de eleição, na maioria dos casos, com bons resultados, apenas com uma pequena proporção de pacientes requerendo tratamento cirúrgico. ¨

 

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by Dr Paulo Fernando Leite

Cardiologia/Prevenção Cardiovascular

Estratificação de Risco Cardiovascular

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