A relação entre o desequilíbrio muscular e a translação anterior da tíbia após a reconstrução do ligamento cruzado anterior
Data
2022-11-08
Autores
Hajaar, Ursula Peyro Berger 
Orientadores
Abdalla, Rene Jorge
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
“Introdução: Em razão da dificuldade na retomada da força muscular da coxa após a reconstrução do ligamento cruzado anterior próximo a alta do paciente e possíveis alterações no enxerto, resolveu-se investigar a possível correlação entre esses dois fatores. Objetivo: Avaliar a incidência de translação anterior da tíbia, medida com artrômetro KT-1000® aos 6 meses após a reconstrução do ligamento cruzado anterior e se esse fator pode estar relacionado ao desequilíbrio muscular, medido pelo isocinético com dinamômetro Biodex® deste mesmo período. Caso haja correlação entre eles, verificar se estão associados ao tipo do enxerto utilizado. Métodos: Foram avaliados 340 pacientes submetidos à reconstrução primária do ligamento cruzado anterior unilateral com autoenxerto do tendão patelar e semitendíneo-grácil. O teste de Mann-Whitney avaliou as variáveis: sexo, joelho operado/dominante e tipo de enxerto, enquanto a correlação de Spearman avaliou a relação entre a translação anterior da tíbia com o desequilíbrio muscular com as mesmas variáveis. Resultados: A translação anterior da tíbia se mostrou dentro dos parâmetros normativos sem diferença com relação ao sexo (p=0,248), joelho operado/dominante (p=0,169) e enxerto (p=0,669). No teste isocinético, as variáveis sexo e joelho operado/dominante demostrou déficit dos músculos flexores, com prevalência nas mulheres e, com relação ao membro operado/dominante era diferente (p<0,001). Houve diferença no déficit dos quadríceps e na razão agonista/antagonista do membro operado com predominância do tendão patelar (p<0,001) e déficit dos flexores com predominância do tendão do semitendíneo-grácil (p<0,001). Houve correlação entre a translação anterior
da tíbia com déficit de força dos flexores (r=0,277 e p=0,027) e na razão agonista/antagonista (r=0,339 e p=0,009) nos pacientes do sexo feminino. Conclusão: O teste artrômetro KT-1000® demostrou estar dentro dos parâmetros normativos. Existe correlação entre a translação anterior da tíbia e o déficit de força dos flexores e na razão agonista/antagonista nas mulheres. Não houve diferença estatística com relação ao tipo de enxerto.
“Introduction: Due to the difficulty in reestablish thigh muscle strength after reconstruction of the anterior cruciate ligament near the patient’s discharge and a possible change in the graft, it was decided to investigate the possible correlation between these two factors. Objective: To evaluate the incidence of anterior tibial translation, measured with a KT-1000® arthrometer at 6 months after anterior cruciate ligament reconstruction with patellar tendon and hamstrings graft and whether this factor may be related to muscle imbalance, measured by isokinetic with a dynamometer Biodex® in the same period. If there is a correlation between them, check whether they are associated with the type of graft used. Methods: A total of 340 patients who underwent primary unilateral anterior cruciate ligament reconstruction with patellar tendon and hamstrings tendon autografts were evaluated. The Mann-Whitney test evaluated the variables: sex, operated/dominant knee, and graft type, while the Spearman test correlate evaluated the relationship between anterior tibial translation and muscle imbalance with the same variables. Results: Anterior tibial translation was within the normative parameters with no difference regarding sex (p=0,248), operated/dominant knee (p=0,169) and graft (p=0,669). In the isokinetic test, the variables sex and operated/dominant knee showed deficits in flexor muscles, and prevalence in women and, in relation to the operated/dominant limb, it was different (p<0,001). There was a difference in quadriceps deficit and in the agonist/antagonist ratio of the operated limb with predominance of the patellar tendon (p<0,001) and deficits of the flexors with predominance of the semitendinosus-gracilis tendon (p<0,001). There was a correlation between anterior tibial translation with deficit in flexor strength (r=0.277 and 0=0.027) and agonist/antagonist ratio (r=o.339 and p=0.009) in female patients. Conclusion: The KT-1000® arthrometer test proved to be within the normative parameters. There is a correlation between anterior tibial translation with flexor strength deficit and agonist/antagonist ration in female patients. There was no statistical difference regarding graft types
“Introduction: Due to the difficulty in reestablish thigh muscle strength after reconstruction of the anterior cruciate ligament near the patient’s discharge and a possible change in the graft, it was decided to investigate the possible correlation between these two factors. Objective: To evaluate the incidence of anterior tibial translation, measured with a KT-1000® arthrometer at 6 months after anterior cruciate ligament reconstruction with patellar tendon and hamstrings graft and whether this factor may be related to muscle imbalance, measured by isokinetic with a dynamometer Biodex® in the same period. If there is a correlation between them, check whether they are associated with the type of graft used. Methods: A total of 340 patients who underwent primary unilateral anterior cruciate ligament reconstruction with patellar tendon and hamstrings tendon autografts were evaluated. The Mann-Whitney test evaluated the variables: sex, operated/dominant knee, and graft type, while the Spearman test correlate evaluated the relationship between anterior tibial translation and muscle imbalance with the same variables. Results: Anterior tibial translation was within the normative parameters with no difference regarding sex (p=0,248), operated/dominant knee (p=0,169) and graft (p=0,669). In the isokinetic test, the variables sex and operated/dominant knee showed deficits in flexor muscles, and prevalence in women and, in relation to the operated/dominant limb, it was different (p<0,001). There was a difference in quadriceps deficit and in the agonist/antagonist ratio of the operated limb with predominance of the patellar tendon (p<0,001) and deficits of the flexors with predominance of the semitendinosus-gracilis tendon (p<0,001). There was a correlation between anterior tibial translation with deficit in flexor strength (r=0.277 and 0=0.027) and agonist/antagonist ratio (r=o.339 and p=0.009) in female patients. Conclusion: The KT-1000® arthrometer test proved to be within the normative parameters. There is a correlation between anterior tibial translation with flexor strength deficit and agonist/antagonist ration in female patients. There was no statistical difference regarding graft types
Descrição
Citação
HAJAAR, Ursula Peyro Berger. A relação entre o desequilíbrio muscular e a translação anterior da tíbia após a reconstrução do ligamento cruzado anterior. 2022. 94 f. Dissertação (Mestrado em Cirurgia Translacional) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2022.