Inácio André Manoel, Lopes Júnior Osmar Valadão, Kuhn André, Saggin José Idílio, Fernandes Saggin Paulo Renato, de Freitas Spinelli Leandro, de Castro Daniela Medeiros
Institute of Orthopedics and Traumatology of Passo Fundo, Passo Fundo, RS, Brazil.
Institute of Orthopedics and Traumatology of Passo Fundo, Passo Fundo, RS, Brazil ; Hospital São Vicente de Paulo, Passo Fundo, RS, Brazil.
Rev Bras Ortop. 2014 Oct 22;49(6):619-24. doi: 10.1016/j.rboe.2014.10.004. eCollection 2014 Nov-Dec.
To evaluate a series of patients who underwent surgery for reconstruction of the anterior cruciate ligament with flexor tendons, by means of the anteromedial transportal technique using Rigidfix for femoral fixation, and to analyze the positioning of the pins by means of tomography.
Thirty-two patients were included in the study. The clinical evaluation was done using the Lysholm, subjective IKDC and Rolimeter. All of them underwent computed tomography with 3D reconstruction in order to evaluate the entry point and positioning of the Rigidfix pins in relation to the joint cartilage of the lateral condyle of the femur.
The mean Lysholm score obtained was 87.81 and the subjective IKDC was 83.72. Among the 32 patients evaluated, 43% returned to activities that were considered to be very vigorous, 9% vigorous, 37.5% moderate and 12.5% light. In 16 patients (50%), the distal entry point of the Rigidfix pin was located outside of the cartilage (extracartilage); in seven (21.87%), the distal pin injured the joint cartilage (intracartilage); and in nine (28.12%), it was at the border of the lateral condyle of the femur.
The patients who underwent ACL reconstruction by means of the anteromedial transportal using the Rigidfix system presented satisfactory clinical results over the length of follow-up evaluated. However, the risk of lesions of the joint cartilage from the distal Rigidfix pin needs to be taken into consideration when the technique via an anteromedial portal is used. Further studies with larger numbers of patients and longer follow-up times should be conducted for better evaluation.
通过采用Rigidfix进行股骨固定的前内侧入路技术，对一系列接受前交叉韧带重建手术并使用屈肌腱的患者进行评估，并通过断层扫描分析钢针的定位情况。
32例患者纳入本研究。采用Lysholm评分、主观国际膝关节文献委员会（IKDC）评分和旋转计进行临床评估。所有患者均接受了三维重建计算机断层扫描，以评估Rigidfix钢针相对于股骨外侧髁关节软骨的进针点和定位情况。
获得的平均Lysholm评分为87.81，主观IKDC评分为83.72。在评估的32例患者中，43%恢复了被认为是非常剧烈的活动，9%为剧烈活动，37.5%为中等强度活动，12.5%为轻度活动。在16例患者（50%）中，Rigidfix钢针的远端进针点位于软骨外（软骨外）；7例（21.87%）中，远端钢针损伤了关节软骨（软骨内）；9例（28.12%）中，其位于股骨外侧髁的边缘。
在评估的随访期内，采用Rigidfix系统通过前内侧入路进行前交叉韧带重建的患者临床效果良好。然而，当使用经前内侧入路技术时，需要考虑远端Rigidfix钢针损伤关节软骨的风险。应进行更多患者数量和更长随访时间的进一步研究，以进行更好的评估。
