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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(05): e760-e765
DOI: 10.1055/s-0043-1776138
Artigo Original
Joelho

Fatores de risco para formação de lesão cyclops sintomática após a reconstrução do ligamento cruzado anterior

Article in several languages: português | English
Camilo Partezani Helito 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
2   Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
3   Hospital Sírio Libanês, São Paulo, SP, Brasil
,
Andre Giardino Moreira da Silva 
2   Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Pedro Nogueira Giglio 
2   Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Vitor Barion Castro de Pádua 
4   Departamento de Ortopedia, Faculdade de Medicina da Universidade de Marilia, Marilia, SP, Brasil
,
José Ricardo Pécora 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
2   Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Riccardo Gomes Gobbi 
1   Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
2   Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Resumo

Objetivo Avaliar a incidência de lesões cyclops sintomáticas que precisam de tratamento cirúrgico após a reconstrução do ligamento cruzado anterior (LCA) e estabelecer os possíveis fatores de risco intraoperatórios relacionados a elas.

Métodos Trezentos e oitenta e nove pacientes com idades entre 18 e 50 anos submetidos à reconstrução primária do LCA foram avaliados de forma retrospectiva. Os pacientes foram divididos em grupos de acordo com a presença ou ausência de lesões cyclops sintomáticas e suas características foram comparadas. Não foram incluídos pacientes com lesões associadas que necessitassem de outros procedimentos cirúrgicos (à exceção de procedimentos extra-articulares ântero-laterais). A taxa de lesões cyclops sintomáticas foi registrada e os seguintes parâmetros foram avaliados: idade, sexo, tempo da lesão à cirurgia, tipo e diâmetro do enxerto, técnica de perfuração do túnel femoral, tipo de fixação, presença de hiperextensão do joelho, preservação do LCA remanescente, associação a procedimento extra-articular ântero-lateral, lesão de menisco associada e participação em esportes.

Resultados Dos 389 pacientes avaliados, 26 (6,7%) desenvolveram lesão cyclops. Os pacientes com e sem lesão cyclops não diferiram quanto à idade, tempo da lesão à cirurgia, tipo ou diâmetro do enxerto, técnica cirúrgica, método de fixação femoral, presença de hiperextensão do joelho, preservação do LCA remanescente e lesão de menisco associada. O grupo com lesão cyclops apresentou mais mulheres (10 [38,4%] vs. 68 [18,7%]; razão de probabilidades [OR] = 2,7; p = 0,015), maior proporção de reconstrução extra-articular (18 [11,8%] vs. 8 [3,4 %]; OR = 3,8; p = 0,001) e maior proporção de prática esportiva (23 [8,6%] vs. 3 [2,5%]; OR = 3,6; p = 0,026).

Conclusão Em nossa série, 6,7% dos pacientes necessitaram de remoção artroscópica das lesões cyclops. O sexo feminino, a reconstrução extra-articular associada e a prática esportiva foram fatores relacionados a essa lesão. A preservação do menisco remanescente não foi associada à formação de lesões cyclops.

Palavras-chave

amplitude de movimento articular - articulação do joelho - cyclops - ligamento cruzado anterior - ligamentos articulares

Trabalho desenvolvido no Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.




Publication History

Received: 27 July 2022

Accepted: 23 November 2022

Article published online:
30 October 2023

© 2023. 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 commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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