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CC BY 4.0 · Rev Bras Ortop (Sao Paulo)
DOI: 10.1055/s-0044-1779335
Artigo de Atualização

Novas técnicas de enxertia para reconstrucão do LCA: Artigo de atualização

Article in several languages: português | English
Paulo Henrique Schmidt Lara 
1   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
,
João Victor Novaretti 
1   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
,
Gilvan Rodrigues da Silva Nunes 
1   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
,
Moises Cohen 
2   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brasil
,
Leonardo Addêo Ramos 
3   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil
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Resumo

A reconstrução do ligamento cruzado anterior (LCA) é um procedimento comum para lesões desse ligamento, especialmente em atletas. Existem diferentes tipos de enxertos utilizados, e a escolha depende de vários fatores. Os enxertos autólogos, do próprio paciente, são a opção mais comum, com rápida incorporação e menor taxa de falha. Enxertos aloenxertos, de doadores, têm seu papel em casos específicos. Os enxertos sintéticos, usados na década de 80, têm vantagens como ausência de morbidade no local doador, mas estudos mostraram complicações a longo prazo. Os enxertos híbridos, combinando enxertos autólogos e aloenxertos, têm ganhado interesse, permitindo um diâmetro maior e reduzindo a morbidade. O enxerto autólogo do tendão do músculo fibular longo tem recebido atenção, com resultados positivos, boa função do joelho e menor hipotrofia da coxa no local doador. O enxerto autólogo do tendão quadricipital tem ganhado popularidade, com resultados comparáveis aos enxertos de tendão patelar e de flexores, menor morbidade no local doador e menor taxa de re-ruptura. A escolha do enxerto evoluiu, com os enxertos autólogos de flexores sendo preferidos para pacientes menos ativos e o enxerto patelar com fragmento ósseo para atletas de alta performance. Enxertos aloenxertos, sintéticos e híbridos têm seu papel em circunstâncias específicas. A escolha deve ser baseada em evidências científicas, considerando vantagens e desvantagens. A reconstrução do LCA é um procedimento complexo que requer considerações individuais para selecionar o enxerto mais adequado.

Palavras-chave

enxerto - joelho - ligamento cruzado anterior

Suporte Financeiro

Não houve apoio financeiro de fontes públicas, comerciais ou sem fins lucrativos.


Trabalho desenvolvido no Centro de Traumatologia do Esporte da Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.




Publication History

Received: 12 July 2023

Accepted: 10 August 2023

Article published online:
23 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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