RESULTADO CLÍNICO APÓS RECONSTRUÇÃO LIGAMENTAR BICRUZADO DO JOELHO, EM DOIS TEMPOS

Abstract

Introduction: Bicruciate knee ligament injury has not a well-establish surgical protocol in the literature. Objective: To correlate clinical data and intraoperative findings compared to the postoperative evaluation data from Lysholm scale, Tegner activity score and SF-36 questionnaire after bicruciate knee ligament two-stage reconstruction. Materials and Methods: 25 patients (20 males and 05 females) were evaluated, mean age 32.3 years (17 - 53 years), mean BMI 26.2(18.9 -34.9), mean duration of lesion 18.3 months (chronic lesion). The INLAY technique was applied in PCL reconstruction using the central 1/3 of the patellar tendon. After the 3-months minimum interval, ACL reconstruction was arthroscopically performed using hamstrings. An additional surgical procedure was required for 04 patients (patellar tendon -02 cases, MCL-02 cases). Results: With a 24.8-month mean follow-up, in 60% of cases, the posterior drawer test rated zero or + (0.5 cm), while 40% as + + (1cm) and 60% of patients rated good condition/ excellent (Lysholm). Only one patient achieved the pre-lesion Tegner activity level.  The duration of lesion influenced postoperative clinical results negatively, especially regarding parameters such as physical functioning limitation of physical aspects, vitality and mental health (SF-36). Conclusion: the bicruciate knee ligament two-stage reconstruction improved the knee stability and subjective evaluation, but, 96% of patients did not recover the pre-injury status of physical activity. Moreover, the time of injury had an inverse statistical correlation with the subjective evaluation of physical functioning, limitation of physical aspects, vitality and mental health in the S-36 score.