Enxerto espesso versus técnica de duplo feixe na reconstrução do ligamento cruzado posterior: Estudo experimental biomecânico com cadáveres*

João Alberto Ramos Maradei-Pereira; Alexandre Estevão Vamos Kokron; César Augusto Martins Pereira; Marco Martins Amatuzzi

doi:10.1016/j.rboe.2017.12.010

Revista Brasileira de Ortopedia, Table of Contents

CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(05): 531-539
DOI: 10.1016/j.rboe.2017.12.010

Artigo Original | Original Article

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Thick Graft Versus Double-Bundle Technique on Posterior Cruciate Ligament Reconstruction: Experimental Biomechanical Study with Cadavers^[*]

Article in several languages: português | English

João Alberto Ramos Maradei-Pereira

¹Faculdade de Medicina, Universidade Federal do Pará, Belém, PA, Brasil

²Clínica dos Acidentados, Hospital Maradei, Belém, PA, Brasil

³Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil

,

Alexandre Estevão Vamos Kokron

³Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil

,

César Augusto Martins Pereira

³Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil

,

Marco Martins Amatuzzi

³Laboratório de Investigação Médica (LIM-41), Instituto de Ortopedia e Traumatologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brasil

› Author Affiliations

Abstract

Objective To evaluate the biomechanical effect of graft thickness compared with the double-bundle technique on posterior cruciate ligament (PCL) reconstruction in human cadaveric knees.

Methods A total of 9 human cadaveric knees were tested in 5 conditions: intact knee (INT); single-bundle reconstruction with a 10-mm quadriceps tendon (SB); double-bundle reconstruction with a 10 mm-quadriceps tendon for the anterolateral bundle and a 7-mm doubled semitendinosus tendon for the posteromedial bundle (DB); single-bundle reconstruction with a 10-mm quadriceps tendon plus a 7-mm doubled semitendinosus tendon (SBT); and PCL-deficient (NoPCL). The posterior tibial translation (PTT) was measured in response to a 134-N posterior tibial load at 0^∘, 30^∘, 60^∘ e 90^∘ of knee flexion.

Results The PTT values of the DB and SBT techniques were always significantly lower (better stability) than those of the SB technique. The PTT values of the SBT technique were significantly lower than those of the DB technique at 60^∘ (p = 0.005) and 90^∘ (p = 0.001).

Conclusions Graft enlargement improves knee stability in isolated PCL reconstructions, whereas the graft division in the two-bundle technique worsens this stability at 60^∘ and 90^∘ of knee flexion. The findings of the present study suggest that knee stability in PCL reconstructions may be improved with the use of thicker grafts in the SB technique rather than performing the DB technique.

Keywords

knee injuries - posterior cruciate ligament - biomechanical phenomena - cadaver - posterior cruciate ligament reconstruction

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References

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Thick Graft Versus Double-Bundle Technique on Posterior Cruciate Ligament Reconstruction: Experimental Biomechanical Study with Cadavers[*]

Thick Graft Versus Double-Bundle Technique on Posterior Cruciate Ligament Reconstruction: Experimental Biomechanical Study with Cadavers^[*]