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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(04): 612-618
DOI: 10.1055/s-0041-1741022
Artigo Original
Ombro e Cotovelo

Validação clínica do conceito de glenoid track na instabilidade glenoumeral anterior

Article in several languages: português | English
Mauro Emilio Conforto Gracitelli 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Frederico Lafraia Lobo 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Eduardo Angeli Malavolta 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Jorge Henrique Assunção 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Fernando Brandão de Andrade-Silva 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Arnaldo Amado Ferreira Neto 
1   Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Resumo

Objetivo Avaliar a correlação do conceito de glenoid track e da perda óssea da cavidade glenoidal com a taxa de recidiva de luxação e pontuação na escala de Rowe.

Métodos Estudo retrospectivo que aferiu o glenoid track e a perda óssea da cavidade glenoidal por ressonância magnética pré-operatória. Foram incluídos pacientes submetidos a reparo artroscópico primário de Bankart anterior. Não foram incluídos pacientes com perda óssea da cavidade glenoidal maior que 21%, rotura do manguito rotador, fratura de cintura escapular, instabilidade posterior ou multidirecional. A pontuação pela escala de Rowe foi o desfecho primário, e a taxa de recidiva foi o desfecho secundário.

Resultados Cento e dois pacientes foram incluídos. A recidiva foi relatada por 8 pacientes (7,8%). Quatro pacientes (50%) do grupo com recidiva apresentaram lesão da cavidade glenoidal maior que 13,5% contra 24 (25,5%) do grupo sem recidiva (p = 0,210), com valor preditivo negativo de 94,6%. Três pacientes (37,5%) do grupo com recidiva foram considerados off-track, contra 13 (13,8%) do grupo sem recidiva (p = 0,109), com valor preditivo negativo de 94,2%. Pacientes com valor absoluto do glenoid track menor ou igual a 1,5 mm tiveram piores resultados em relação ao grupo com recidiva, sendo que 6 pacientes (75%) apresentaram recidiva (p = 0,003).

Conclusão Lesão off-track e perda óssea da cavidade glenoidal maior que a subcrítica não apresentam relação significativa com a taxa de recidiva e a pontuação de Rowe, apesar do alto valor preditivo negativo. O corte do valor absoluto do glenoid track em 1,5 mm apresentou relação significativa com a taxa de recidiva.

Palavras-chave

lesões de Bankart - cavidade glenoide - luxação do ombro

Suporte financeiro

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Trabalho desenvolvido na Cirurgia do Ombro e Cotovelo, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.




Publication History

Received: 15 April 2021

Accepted: 09 September 2021

Article published online:
15 February 2022

© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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