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    Avaliação morfológica das lesões meniscais associadas as lesões ligamento do cruzado anterior
    (Universidade Federal de São Paulo (UNIFESP), 2019-10-18) Gomes, Daniel Esperante [UNIFESP]; Cohen, Moises [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Anterior cruciate ligament (ACL) reconstruction restores the natural knee’s kinematics and protects this joint by decreasing the incidence of meniscal and cartilage injuries. Over the years, the search for better results and lower morbidity has led to the evolution of ACL reconstruction techniques Anatomical reconstruction aims to place the ACL tunnels in the most similar position of the origin and insertion of the ACL footprint. For this, the all-inside reconstruction technique, that preserves femoral and tibial bone cortex, is the first choice. Another advantage is the preservation of the gracilis tendon and lower morbidity to the tendon donor site. Criticisms of this technique include the possibility of progressive graft loosening due to the use of an adjustable-length loop cortical button and graft prepare. The aim of this study is to evaluate the clinical and functional results of knee stability after 2 years of anatomical all-inside reconstruction of the ACL. Methods: This is an observational, cross-sectional study conducted in a private clinic in the city of São Paulo that aimed to evaluate patients undergoing anatomical ACL reconstruction using the all inside technique and adjustable-length loop cortical button, from March 2013 to June 2016, performed by the same surgeon. The following outcomes were analyzed: graft diameter, gender, age, time to surgery, presence or absence of meniscal injury and treatment of meniscal injury. Patients were included in the study to assess objective stability using the KT1000™ arthrometer and subjective IKDC questionnaires and Lysholm score. Results: Results were obtained from 49 patients aged 39.7 years (SD = 10.5 years). It was found that 73.5% (n = 36) of the patients were men, 81.6% (n = 40) had surgery in the first 3 months after the initial trauma, 53.0% (n = 26) had no meniscal injury and, when there was injury, most were in the medial meniscus (n = 15). The average graft diameter was 9.0 mm (SD = 0.9 mm). Objective stability assessment with the KT1000™ arthrometer showed that 79.6% of patients (n = 39) had less than 2mm of looseness compared with the contralateral side, 12.2% (n = 6) between 3-5mm and 8.2% (n = 4) between 5-10mm. In the subjective IKDC questionnaire and Lysholm score 2 years after surgery, no correlation was found with the degree of loosening. Conclusions: We found that 39 of the patients (79.6%) who underwent anatomical ACL reconstruction with adjustable-length loop cortical button presented stability with a xv difference less than 2mm of looseness compared to the contralateral side. Lysholm and IKDC scores did not correlate with the degree of objective stability assessed by the KT1000™ arthrometer.