Navegando por Palavras-chave "Menisci, Tibial"

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    Comparação biomecânica das técnicas de sutura vertical e cruzada, em configurações de fileira única e dupla, para o tratamento da lesão meniscal medial em alça de balde
    (Universidade Federal de São Paulo (UNIFESP), 2020-07-01) Nakama, Gilberto Yoshinobu [UNIFESP]; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo
    Background: Due to a variety of suturing techniques for bucket-handle meniscal repair, it is important to assess which suturing technique best restores native biomechanics. Purpose: To biomechanically compare vertical mattress and cross-stitch suture techniques, in single- and doublerow configurations, in their ability to restore native knee kinematics in a bucket-handle medial meniscus tear model. Methods: Ten matched pairs of human cadaver knees were randomly assigned to vertical mattress (n = 10) or cross-stitch (n = 10) repair groups. Each knee underwent four consecutive testing conditions: (1) intact, (2) displaced bucket-handle tear, (3) single-row suture configuration on the femoral meniscus surface, and (4) double-row suture configuration (repair of both femoral and tibial meniscus surfaces). Knees were loaded with a 1000 N axial compressive force at 0°, 30°, 60°, 90° and 120° of flexion for each condition. Resultant medial compartment contact area, average contact pressure, and peak contact pressure data were recorded. Results: Intact state contact area was not restored at 0° (P = 0.027) for the vertical double-row configuration and at 0° (P = 0.032), 60° (P < 0.001) and 90° (P = 0.007) of flexion for the cross-stitch double-row configuration. No significant differences were found in the average contact pressure and peak contact pressure between the intact state and the vertical mattress and cross-stitch repairs with either single- and double-row configurations at any flexion angles. When comparing the vertical and crossstich repairs across all flexion angles, no significant differences were observed in single-row configurations, but in double-row configurations, cross-stitch repair resulted in a significantly decreased contact area, average contact pressure and peak contact pressure (all P < 0.001). Conclusion: XVII Single- and double-row configurations of both vertical mattress and crossstitch inside-out meniscal repair techniques restored native tibiofemoral pressure after a medial meniscus bucket-handle tear at all assessed knee flexion angles. Despite decreased contact area using a double-row configuration, mainly related to the cross-stitch repair, in comparison to the intact state, the cross-stitch double-row repair led to decreased pressure in comparison to the vertical double-row repair. These findings are only applicable at the time of the surgery.