Comparação do pós-operatório com enxerto autólogo de tendão patelar versus semitendíneo e grácil na reconstrução do ligamento cruzado anterior: diferenças, morbidades e complicações

Abstract

The rupture of the Anterior Cruciate Ligament (ACL) is very frequent, especially in high performance sports. The ACL injury creates instability in the knee, and could evolve in a negative way when not treated properly. The surgical treatment is not mandatory, but when is necessary it cause a debate about what would be the best graft for the reconstruction. Two types of grafts have been used frequently, the patellar tendon (PT) and semitendinosus and gracillis tendon (ST-G). The objective of this study was to demonstrate what are the negative and positive effects of each graft. This narrative review was composed of eleven articles selected from the data sources Medline, Lilacs, Cochrane, Scielo and Pedro in English and Portuguese. The outcomes evaluates were muscle strength, stability, range of motion, pain, function, morbity and complications. Both grafts provide good stability to return to the sport, but the biggest difference was found regarding the morbidities and complications that each donor area provides. The ability to walk on the knees (knee walking) and kneeling had unsatisfactory results in the group PT, as well as anterior knee pain, being more common in the PT group. Two studies showed higher degrees of ligament laxity in the ST-G group, and about the muscle strength, PT graft reconstructions lead to an extensor strength deficit and ST-G graft reconstruction to a flexor strength deficit.