Sutura de menisco com implantes absorvíveis

Abstract

Os autores avaliam clinicamente 19 pacientes (19 joelhos - 15 meniscos mediais e 5 laterais) submetidos à sutura de menisco, utilizando 2 tipos de implantes absorvíveis (ácido polilático) Arrow® e Clear fix®. O estudo compõe-se de 15 homens e 4 mulheres com idades entre 16 e 44 anos, com média de 26,8 anos. O tempo de seguimento médio foi de 24 meses, com mínimo de 18 e máximo de 32 meses. A técnica operatória constituiu-se da sutura de um ou ambos os meniscos (1 caso), via artroscópica com Arrow® em 15 pacientes e Clear fix® em 4. Dos 19 indivíduos, 6 foram submetidos à sutura meniscal isolada, 11 associada à reconstrução do LCA e 2 à reconstrução do LCA com osteotomia valgizante da tíbia. Os resultados foram avaliados segundo exame físico incluindo as manobras de Appley e Mc Murray. A avaliação funcional pré e pós-operatória do joelho foi realizada pela escala de Lysholm modificada. Todos os pacientes tiveram suas manobras meniscais negativadas no pós-operatório. A pontuação média pré-operatória segundo a escala de Lysholm foi de 39,8 subindo para 91,5 no pós-operatório. Os autores concluem que a sutura de menisco, utilizando implantes absorvíveis, tem se mostrado eficiente até o momento, e que tecnicamente ela é mais simples que a sutura convencional.

Meniscal repair by all-inside technique with Fast-Fix device

“…This can be demonstrated partly by the relative scarcity of studies published in the Brazilian literature on this topic and partly by the difficulty of having these devices released for use through healthcare service agreements and within the Brazilian National Health System (SUS), given that they make the final cost of surgery higher. Auditors and managers do not understand the real benefit that this increased expenditure brings for patients and consequently deny requests to use these devices 23, 24, 25. The technological gap that exists between Brazil and more developed countries should also be mentioned, considering that approval for devices developed outside of Brazil that are more advanced ends up being delayed by controlling bodies.…”

Importância do ligamento femoropatelar medial no deslocamento e na inclinação lateral da patela: estudo radiográfico em cadáveres

“…Atkin et al 10 , describe that after 06 months from an acute patellar luxation episode, more than half of the patients from his set presented limitation for extenuating physical activities. This high index of unsatisfactory results in the treatment of acute patellar luxation, many of which practitioners of sports activities, stimulated us to investigate the patellar biomechanical functioning through its main medial static stabilizer, the medial patellofemoral ligament (1,2) . The MPFL was initially described by Kaplan, in 1957 (15) , but he did not name it.…”

“…The study of the disorders between the patella and femur is of great relevance not only for their high prevalence but also for the expressive number of cases of difficult solution, especially in athletes, this context becomes more complex (1,2) The current literature has emphasized the importance of the injury of the medial patellofemoral ligament (MPFL) in acute patellar luxation, since it is the main static stabilizer of the medial side of the patella and is the first structure injured in this condition (1)(2)3,4) (figure 1). Many authors use different imaging methods to refer to the MFPL injury as an essential factor in the patellar instability after an acute patellar luxation episode (5)(6)(7) .…”