Estudo comparativo da reconstrução do LCA com o posicionamento anatômico dos túneis entre o tendão patelar e os tendões flexores

Abstract

The authors declare that there was no conflict of interest in conducting this work ABSTRACTObjective: To compare ACL reconstruction with anatomical positioning of the tunnels using the hamstring or patellar tendons. Methods: We prospectively evaluated 52 patients who underwent ACL reconstruction using the Chambat's technique, with anatomical positioning of the tunnels drilled outside in. They were divided into group A, with 27 patients, using the patellar tendon as a graft, and group B, with 25 patients, using the hamstring. Results: In group A 26 patients were very satisfied or satisfied and 1 unhappy, in group B. 25 patients were very satisfied or satisfied with the procedure (p = 0.990). According to the Lysholm scale, group A had a mean score of 96.11 and group B, 95.32 (p=0.594). In relation to preoperative IKDC, 100% of the patients in group A and 92% of those in group B were IKDC C or D (p = 0.221); in the assessment with a minimum of two-year follow-up, 96% of group A and 92% of group B were IKDC A or B (p = 0.256). The Lachman test, pivot shift, return to sports activities, and the comparative difference in anterior translation (Rolimeter TM ) also showed no statistically significant difference. In group A, 5 patients (18.5%) were unable to kneel on a hard surface, whereas no patient in group B had this complaint. Conclusion: The anterior cruciate ligament reconstruction presents similar results using the hamstring or patellar tendon with anatomical positioning of the tunnels. Drilling the femoral tunnel outside in is a reproducible and accurate option in the correct placement the femoral tunnel.

Lesão do nervo safeno na retirada de 1 ou 2 tendões flexores na reconstrução do ligamento cruzado anterior

“…A fáscia do sartório que recobre os tendões flexores é aberta horizontalmente e com ajuda de dois "mixter" isola-se o ST e se faz sua retirada através de um "stripper" aberto (tipo rabo de porco) mantendo sua inserção distal na tíbia. 6 Faz-se a limpeza da parte muscular e inicia-se o procedimento artroscópico através dos portais convencionais anteromedial e anterolateral. Após o tratamento das lesões associadas, verifica-se a existência de remanescentes viáveis de LCA e prepara-se o fêmur para perfuração do túnel que é feita através da perfuração independente e de fora para dentro pela técnica de Chambat.…”