Correlação do sexo, idade e testes funcionais para retorno ao esporte na relesão do ligamento cruzado anterior: coorte prospectiva com mais de 10 anos de seguimento
Arquivos
Data
2024-08-12
Autores
Sallum, Andrea Forgas 
Orientadores
Abdalla, Rene Jorge
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O Ligamento Cruzado Anterior (LCA) é um dos ligamentos mais importantes do joelho. A taxa de relesão ipsilateral do LCA é considerada alta pela literatura. Sabemos que a falha do enxerto é multifatorial portanto, não há uma razão específica ou única, sendo incluída a idade jovem, tipo de enxerto, diâmetro do enxerto e erros de técnica cirúrgica. Objetivo: Correlacionar o sexo, a idade e os resultados dos testes funcionais de retorno ao esporte aplicados entre o 5º e o 8º mês pós-operatório de LCA com a taxa de relesão de LCA e lesão de LCA contralateral a curto (até 5 anos), médio (entre 5 e 10 anos) e longo prazo (mais que 10 anos). Método: Foram analisados 1155 prontuários de pacientes submetidos a reconstrução do LCA, de ambos os gêneros. Sendo elegíveis 234 pacientes com reconstrução do LCA primária sem lesão associada, idade entre 18 e 50 anos, acompanhados no pós- cirúrgico por pelo menos 8 meses de pós-operatório e que assinaram o termo de consentimento livre e esclarecido. Foram coletadas 25 variáveis distintas dos prontuários ou por contato telefônico. Resultados: A idade do paciente no momento da lesão primária apresentou correlação com a taxa de relesão do LCA (p= 0,028) e encontramos que a taxa de relesão esta associada em pacientes que jogam futebol com o sexo masculino e apresentaram valgo dinâmico no momento da alta (p= 0,001 e p= 0,034). Foi encontrada diferença significativa no uso do enxerto de flexores com a fraqueza de flexores e o uso do tendão patelar com a fraqueza de quadríceps. Conclusão: A idade tem relação importante com a taxa de relesão do enxerto. E o futebol com o valgo dinâmico e o sexo masculino apresenta relação importante com a taxa de relesão do enxerto do LCA.
Introduction: The Anterior Cruciate Ligament is one of the most important ligaments of the knee. The rate of ipsilateral ACL re-injury is considered high in the literature. We know that graft failure is multifactorial, therefore, there is no specific or unique reason, including young age, type of graft, graft diameter and errors in surgical technique. Objective: To correlate sex, age and the results of return-to-sport functional tests applied between the 5th and 8th month after ACL surgery with the rate of ACL re-injury and short contralateral ACL injury (up to 5 years), medium (between 5 and 10 years) and long term (more than 10 years). Method: 1155 medical records of patients undergoing ACL reconstruction, of both genders, were analyzed. Patients with primary ACL reconstruction were eligible, aged between 18 and 50 years, followed post-surgery for at least 8 months post-operatively and who signed the informed consent form. 25 different variables were collected from medical records or by telephone contact. Results: The patient's age at the time of the primary injury was correlated with the rate of ACL re-injury (p = 0.028). We found that the rate of re-injury is associated with patients who play soccer, are male, and exhibited dynamic valgus at the time of discharge (p < 0.001 and p = 0.034). A significant difference was found between the use of hamstring grafts and hamstring weakness, and the use of patellar tendon grafts and quadriceps weakness. Conclusion: Age has an important relationship with the rate of graft re-injury. Additionally, playing soccer, dynamic valgus, and being male are significantly associated with a higher rate of ACL graft re-injury.
Introduction: The Anterior Cruciate Ligament is one of the most important ligaments of the knee. The rate of ipsilateral ACL re-injury is considered high in the literature. We know that graft failure is multifactorial, therefore, there is no specific or unique reason, including young age, type of graft, graft diameter and errors in surgical technique. Objective: To correlate sex, age and the results of return-to-sport functional tests applied between the 5th and 8th month after ACL surgery with the rate of ACL re-injury and short contralateral ACL injury (up to 5 years), medium (between 5 and 10 years) and long term (more than 10 years). Method: 1155 medical records of patients undergoing ACL reconstruction, of both genders, were analyzed. Patients with primary ACL reconstruction were eligible, aged between 18 and 50 years, followed post-surgery for at least 8 months post-operatively and who signed the informed consent form. 25 different variables were collected from medical records or by telephone contact. Results: The patient's age at the time of the primary injury was correlated with the rate of ACL re-injury (p = 0.028). We found that the rate of re-injury is associated with patients who play soccer, are male, and exhibited dynamic valgus at the time of discharge (p < 0.001 and p = 0.034). A significant difference was found between the use of hamstring grafts and hamstring weakness, and the use of patellar tendon grafts and quadriceps weakness. Conclusion: Age has an important relationship with the rate of graft re-injury. Additionally, playing soccer, dynamic valgus, and being male are significantly associated with a higher rate of ACL graft re-injury.
Descrição
Citação
SALLUM, Andrea Forgas. Correlação do sexo, idade e testes funcionais para retorno ao esporte na relesão do ligamento cruzado anterior: coorte prospectiva com mais de 10 anos de seguimento. 2024. 110 f. Tese (Doutorado em Cirurgia Translacional) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.