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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(02): e189-e198
DOI: 10.1055/s-0044-1785493
Artigo Original
Artroscopia e Trauma Esportivo

Influência dos parâmetros do túnel e do ângulo de inclinação do enxerto no desfecho clínico e radiológico no acompanhamento de longo prazo após a reconstrução artroscópica do ligamento cruzado anterior

Article in several languages: português | English
Thatchinamoorthy Santhamoorthy 
1   Departamento de Ortopedia, Indira Gandhi Government General Hospital and Postgraduate Institute, Puducherry, Índia
,
Anish Anto Xavier 
1   Departamento de Ortopedia, Indira Gandhi Government General Hospital and Postgraduate Institute, Puducherry, Índia
,
Kaliaperumal Krun 
2   Departamento de Ortopedia, Indira Gandhi Medical College and Research Institute, Puducherry, Índia
,
Dharamveer Kumar Dubey 
1   Departamento de Ortopedia, Indira Gandhi Government General Hospital and Postgraduate Institute, Puducherry, Índia
› Author Affiliations Suporte Financeiro Este estudo não recebeu qualquer financiamento específico de agências de fomento dos setores público, comercial ou sem fins lucrativos.
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Resumo

Objetivo O objetivo deste estudo foi analisar a influência de vários parâmetros do túnel e do ângulo de inclinação do enxerto (GIA, do inglês graft inclination angle) nos desfechos clínicos e radiológicos da reconstrução do ligamento cruzado anterior (RLCA) no acompanhamento de longo prazo.

Métodos Neste estudo retrospectivo, 80 pacientes com lesão isolada do ligamento cruzado anterior (LCA) submetidos à RLCA de feixe único com autoenxertos de tendão patelar ósseo (TPO) e isquiotibiais (IT) foram avaliados clínica e radiologicamente durante o acompanhamento em longo prazo. A população do estudo foi dividida em dois grupos com base nos parâmetros ideais ou não ideais do túnel, bem como no GIA ideal e não ideal. Os vários parâmetros do túnel e o GIA foram interpretados com os desfechos clínicos e radiológicos no acompanhamento em longo prazo.

Resultados Oitenta pacientes, sendo 36 (45%) submetidos ao procedimento com autoenxertos de TPO e 44 (55%) com autoenxertos IT, puderam completar o estudo. Pacientes com ângulo do túnel tibial coronal (ATTC) e ângulo do túnel femoral coronal (ATFC) ideais apresentam resultados clínicos superiores (teste de pivot shift) do que aqueles com ATTC e ATFC não ideais, sendo a diferença estatisticamente significativa (valor de p < 0,038 e 0,024, respectivamente). Da mesma forma, pacientes com posição do túnel tibial coronal (PTTC) ideal apresentam resultado clínico superior (International Knee Documentation Committee [IKDC] objetivo) em relação àqueles com PTTC não ideal (valor de p < 0,017). Os demais parâmetros do túnel e o GIA não influenciaram o desfecho clínico. Nenhum dos parâmetros do túnel influenciou a alteração associada à osteoartrite (OA). Não houve progressão da alteração da OA na população do estudo no acompanhamento em longo prazo após a RLCA.

Conclusão Os parâmetros ideais do túnel coronal produziram um melhor desfecho clínico no acompanhamento de longo prazo após a RLCA. Não houve progressão da alteração da OA no acompanhamento em longo prazo após a RLCA isolada.

Palavras-chave

articulação do joelho - osteoartrite - reconstrução do ligamento cruzado anterior

Trabalho desenvolvido no Departamento de Ortopedia, Indira Gandhi Government General Hospital and Postgraduate Institute, Puducherry, Índia




Publication History

Received: 11 April 2023

Accepted: 06 November 2023

Article published online:
10 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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