RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS

Detalhes bibliográficos
Autor(a) principal: Mituso Inada, Mauro
Data de Publicação: 2020
Outros Autores: Rocha Piedade, Sergio
Tipo de documento: preprint
Idioma: eng
Título da fonte: SciELO Preprints
Texto Completo: https://preprints.scielo.org/index.php/scielo/preprint/view/1525
Resumo: Introduction: Bicruciate knee ligament injury has not a well-establish surgical protocol in the literature. Objective: To correlate clinical data and intraoperative findings compared to the postoperative evaluation data from Lysholm scale, Tegner activity score and SF-36 questionnaire after bicruciate knee ligament two-stage reconstruction. Materials and Methods: 25 patients (20 males and 05 females) were evaluated, mean age 32.3 years (17 - 53 years), mean BMI 26.2(18.9 -34.9), mean duration of lesion 18.3 months (chronic lesion). The INLAY technique was applied in PCL reconstruction using the central 1/3 of the patellar tendon. After the 3-months minimum interval, ACL reconstruction was arthroscopically performed using hamstrings. An additional surgical procedure was required for 04 patients (patellar tendon -02 cases, MCL-02 cases). Results: With a 24.8-month mean follow-up, in 60% of cases, the posterior drawer test rated zero or + (0.5 cm), while 40% as + + (1cm) and 60% of patients rated good condition/ excellent (Lysholm). Only one patient achieved the pre-lesion Tegner activity level.  The duration of lesion influenced postoperative clinical results negatively, especially regarding parameters such as physical functioning limitation of physical aspects, vitality and mental health (SF-36). Conclusion: the bicruciate knee ligament two-stage reconstruction improved the knee stability and subjective evaluation, but, 96% of patients did not recover the pre-injury status of physical activity. Moreover, the time of injury had an inverse statistical correlation with the subjective evaluation of physical functioning, limitation of physical aspects, vitality and mental health in the S-36 score.
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spelling RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOSCLINICAL OUTCOMES AFTER BICRUCIATE KNEE LIGAMENT TWO-STAGE RECONSTRUCTIONligamento cruzado posteriorFerimento no joelhoLigamentosMedidas de resultados relatados pelo pacienteposterior cruciate ligamentKnee injuryLigamentsPatient Reported Outcomes MeasuresIntroduction: Bicruciate knee ligament injury has not a well-establish surgical protocol in the literature. Objective: To correlate clinical data and intraoperative findings compared to the postoperative evaluation data from Lysholm scale, Tegner activity score and SF-36 questionnaire after bicruciate knee ligament two-stage reconstruction. Materials and Methods: 25 patients (20 males and 05 females) were evaluated, mean age 32.3 years (17 - 53 years), mean BMI 26.2(18.9 -34.9), mean duration of lesion 18.3 months (chronic lesion). The INLAY technique was applied in PCL reconstruction using the central 1/3 of the patellar tendon. After the 3-months minimum interval, ACL reconstruction was arthroscopically performed using hamstrings. An additional surgical procedure was required for 04 patients (patellar tendon -02 cases, MCL-02 cases). Results: With a 24.8-month mean follow-up, in 60% of cases, the posterior drawer test rated zero or + (0.5 cm), while 40% as + + (1cm) and 60% of patients rated good condition/ excellent (Lysholm). Only one patient achieved the pre-lesion Tegner activity level.  The duration of lesion influenced postoperative clinical results negatively, especially regarding parameters such as physical functioning limitation of physical aspects, vitality and mental health (SF-36). Conclusion: the bicruciate knee ligament two-stage reconstruction improved the knee stability and subjective evaluation, but, 96% of patients did not recover the pre-injury status of physical activity. Moreover, the time of injury had an inverse statistical correlation with the subjective evaluation of physical functioning, limitation of physical aspects, vitality and mental health in the S-36 score.Introdução: A lesão ligamentar bicruciada do joelho não possui um protocolo cirúrgico bem estabelecido na literatura. Objetivo: Correlacionar os dados clínicos e os achados intra-operatórios com os dados da avaliação pós-operatória da escala de Lysholm, escore de atividade de Tegner e questionário SF-36 após reconstrução do ligamento bicruzado do joelho em dois estágios. Materiais e Métodos: Foram avaliados 25 pacientes (20 homens e 05 mulheres), idade média 32,3 anos (17 - 53 anos), IMC médio 26,2 (18,9 -34,9), duração média da lesão 18,3 meses (lesão crônica). A técnica INLAY foi aplicada na reconstrução do LCP utilizando o 1/3 central do tendão patelar. Após o intervalo mínimo de 3 meses, a reconstrução do LCA foi realizada artroscopicamente com isquiotibiais. Um procedimento cirúrgico adicional foi necessário para 04 pacientes (tendão patelar -02 casos, casos MCL-02). Resultados: Com seguimento médio de 24,8 meses, em 60% dos casos, o teste da gaveta posterior foi avaliado como zero ou + (0,5 cm), enquanto 40% como + + (1cm) e 60% dos pacientes avaliaram bom estado / excelente (Lysholm). Apenas um paciente atingiu o nível de atividade de Tegner pré-lesão. O tempo de lesão influenciou negativamente os resultados clínicos pós-operatórios, principalmente em relação a parâmetros como limitação do funcionamento físico dos aspectos físicos, vitalidade e saúde mental (SF-36). Conclusão: a reconstrução do ligamento bicruzado do joelho em dois estágios melhorou a estabilidade do joelho e a avaliação subjetiva, mas 96% dos pacientes não recuperaram o estado pré-lesão da atividade física. Além disso, o tempo da lesão apresentou correlação estatística inversa com a avaliação subjetiva da capacidade funcional, limitação dos aspectos físicos, vitalidade e saúde mental no escore S-36.SciELO PreprintsSciELO PreprintsSciELO Preprints2020-11-26info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/152510.1590/SciELOPreprints.1525enghttps://preprints.scielo.org/index.php/scielo/article/view/1525/2410Copyright (c) 2020 Mauro Mituso Inada, Sergio Rocha Piedadehttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessMituso Inada, Mauro Rocha Piedade, Sergio reponame:SciELO Preprintsinstname:SciELOinstacron:SCI2020-11-25T21:03:06Zoai:ops.preprints.scielo.org:preprint/1525Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2020-11-25T21:03:06SciELO Preprints - SciELOfalse
dc.title.none.fl_str_mv RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
CLINICAL OUTCOMES AFTER BICRUCIATE KNEE LIGAMENT TWO-STAGE RECONSTRUCTION
title RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
spellingShingle RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
Mituso Inada, Mauro
ligamento cruzado posterior
Ferimento no joelho
Ligamentos
Medidas de resultados relatados pelo paciente
posterior cruciate ligament
Knee injury
Ligaments
Patient Reported Outcomes Measures
title_short RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
title_full RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
title_fullStr RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
title_full_unstemmed RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
title_sort RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS
author Mituso Inada, Mauro
author_facet Mituso Inada, Mauro
Rocha Piedade, Sergio
author_role author
author2 Rocha Piedade, Sergio
author2_role author
dc.contributor.author.fl_str_mv Mituso Inada, Mauro
Rocha Piedade, Sergio
dc.subject.por.fl_str_mv ligamento cruzado posterior
Ferimento no joelho
Ligamentos
Medidas de resultados relatados pelo paciente
posterior cruciate ligament
Knee injury
Ligaments
Patient Reported Outcomes Measures
topic ligamento cruzado posterior
Ferimento no joelho
Ligamentos
Medidas de resultados relatados pelo paciente
posterior cruciate ligament
Knee injury
Ligaments
Patient Reported Outcomes Measures
description Introduction: Bicruciate knee ligament injury has not a well-establish surgical protocol in the literature. Objective: To correlate clinical data and intraoperative findings compared to the postoperative evaluation data from Lysholm scale, Tegner activity score and SF-36 questionnaire after bicruciate knee ligament two-stage reconstruction. Materials and Methods: 25 patients (20 males and 05 females) were evaluated, mean age 32.3 years (17 - 53 years), mean BMI 26.2(18.9 -34.9), mean duration of lesion 18.3 months (chronic lesion). The INLAY technique was applied in PCL reconstruction using the central 1/3 of the patellar tendon. After the 3-months minimum interval, ACL reconstruction was arthroscopically performed using hamstrings. An additional surgical procedure was required for 04 patients (patellar tendon -02 cases, MCL-02 cases). Results: With a 24.8-month mean follow-up, in 60% of cases, the posterior drawer test rated zero or + (0.5 cm), while 40% as + + (1cm) and 60% of patients rated good condition/ excellent (Lysholm). Only one patient achieved the pre-lesion Tegner activity level.  The duration of lesion influenced postoperative clinical results negatively, especially regarding parameters such as physical functioning limitation of physical aspects, vitality and mental health (SF-36). Conclusion: the bicruciate knee ligament two-stage reconstruction improved the knee stability and subjective evaluation, but, 96% of patients did not recover the pre-injury status of physical activity. Moreover, the time of injury had an inverse statistical correlation with the subjective evaluation of physical functioning, limitation of physical aspects, vitality and mental health in the S-36 score.
publishDate 2020
dc.date.none.fl_str_mv 2020-11-26
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dc.identifier.uri.fl_str_mv https://preprints.scielo.org/index.php/scielo/preprint/view/1525
10.1590/SciELOPreprints.1525
url https://preprints.scielo.org/index.php/scielo/preprint/view/1525
identifier_str_mv 10.1590/SciELOPreprints.1525
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://preprints.scielo.org/index.php/scielo/article/view/1525/2410
dc.rights.driver.fl_str_mv Copyright (c) 2020 Mauro Mituso Inada, Sergio Rocha Piedade
https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2020 Mauro Mituso Inada, Sergio Rocha Piedade
https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv SciELO Preprints
SciELO Preprints
SciELO Preprints
publisher.none.fl_str_mv SciELO Preprints
SciELO Preprints
SciELO Preprints
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repository.name.fl_str_mv SciELO Preprints - SciELO
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