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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(06): e868-e875
DOI: 10.1055/s-0044-1785663
Artigo Original
Joelho

A reconstrução do ligamento cruzado anterior com aumento por cerclagem interna resulta em menos rerrupturas em comparação à reconstrução sem aumento

Article in several languages: português | English
João Victor Novaretti 
1   Departamento de Ortopedia e Traumatologia, Centro de Ortopedia e Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Claudio Paula Pessoa Dias Junior 
2   Instituto Cohen, São Paulo, Brasil
,
Lucas Santos Lima 
2   Instituto Cohen, São Paulo, Brasil
,
Joicemar Tarouco Amaro 
2   Instituto Cohen, São Paulo, Brasil
,
Daniel Esperante Gomes 
1   Departamento de Ortopedia e Traumatologia, Centro de Ortopedia e Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Moises Cohen 
3   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
› Author Affiliations Suporte Financeiro Os autores declaram que não receberam financiamento de agências dos setores público, privado ou sem fins lucrativos para a realização deste estudo.
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Resumo

Objetivo Comparar os desfechos clínicos da reconstrução do ligamento cruzado anterior (LCA) usando autoenxertos com e sem aumento por cerclagem interna.

Métodos Os dados de pacientes submetidos à reconstrução do LCA com autoenxertos de tendões isquiotibiais e quadríceps e aumento por cerclagem interna ou não, além de acompanhamento mínimo de um ano, foram coletados de forma prospectiva e analisados retrospectivamente. Os escores funcionais de Lysholm e Tegner foram determinados antes e após a cirurgia, e dados sobre as complicações pós-operatórias também foram coletados. A comparação das médias dos dois grupos foi feita por meio do teste t de Student ou do teste não paramétrico de Mann-Whitney, em caso de rejeição da normalidade dos dados.

Resultados Ao todo, 55 pacientes foram submetidos à reconstrução do LCA com cerclagem interna, e outros 55 pacientes foram submetidos à reconstrução do LCA sem cerclagem interna. Os pacientes tinham entre 16 e 63 anos de idade (média de 32,7 ± 11,4 anos). No total, 62 pacientes (56,4%) foram submetidos à reconstrução do LCA com enxerto de isquiotibiais, e 19 pacientes (17,3%) receberam enxerto de tendão do quadríceps, com variação de diâmetro de 7 mm a 11 mm (média de 8,95 ± 0,83 mm). Os escores pós-operatórios não diferiram entre os grupos (p > 0,05). Quatro pacientes do grupo reconstrução do LCA com cerclagem interna apresentaram complicações: 2 (3,7%) tiveram artrofibrose, 1 (1,8%) sofreu rerruptura, e 1 (1,8%), trombose. No grupo de reconstrução do LCA sem aumento, 7 pacientes manifestaram complicações: 2 (3,9%) tiveram artrofibrose, 4 (7,3%) sofreram rerruptura, e 1 (2%) apresentou infecção.

Conclusão Os resultados deste estudo mostram que houve menos casos de rerruptura do LCA após a reconstrução com aumento por cerclagem interna em comparação à reconstrução do LCA sem aumento, embora os escores funcionais não tenham apresentado diferenças.

Palavras-chave

ligamento cruzado anterior - reconstrução do ligamento cruzado anterior - resultado do tratamento - traumatismos do joelho

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




Publication History

Received: 17 July 2023

Accepted: 06 November 2023

Article published online:
21 December 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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