Comparação entre os resultados funcionais e da estabilidade articular da reconstrução do ligamento cruzado anterior pelas técnicas transportal e transtibial

Abstract

INTRODUCTION: The goals of anterior cruciate ligament surgery are to restore stability and improve function. The transtibial arthroscopic technique had made this procedure as the gold standard treatment in the last decades. However, biomechanics and anatomic studies have brought into question its ability to restore knees homeostasis. The concept of anatomic reconstruction has been developed, as well as the transportal procedure. OBJECTIVES: The objective of this study is to evaluate the clinical results of the anterior cruciate ligament reconstruction through transportal or transtibial technique. METHODS: Sixty-one patients (seventy-one knees) in whom an anterior cruciate reconstruction was made (41knees through a transportal technique and 30 knees through a transtibial technique) were evaluated, considering the functional scores (IKDC and Lysholm), stability (pivot-shift, anterior drawer test, Lachman test and KT-1000- MEDmetrics®) and global articular function (extension and flexion deficit, thigh circumference and monopodalic hop test performance). RESULTS: Transportal technique showed better results in terms of stability than transtibial technique (transportal versus transtibial results, respectively positive pivot-shift: 14.6% versus 60%, p 0.00; positive anterior drawer test: 17.1% versus 53.3%, p 0.002; positive Lachman test: 2.4% versus 20%, p 0.037; arthrometer side-to-side difference (KT-1000-MEDmetrics®) 0.5 mm versus 2 mm, p 0.002). Extension deficit was more evident in the transtibial group (2.5 degrees versus 0.98 degrees, p 0.013). CONCLUSION: in this study, transportal technique gave better results than the transtibial technique regarding articular stability function and articular mobility.