Almeida Alexandre, Roveda Gilberto, Valin Márcio Rangel, Almeida Nayvaldo Couto de, Sartor Vanderlei, Alves Soraya Melina
Orthopedist at Hospital Saúde, Caxias do Sul, RS.
Resident in the Orthopedics and Traumatology Service, Hospital Pompeia, Caxias do Sul, RS.
Rev Bras Ortop. 2015 Dec 12;45(5):409-14. doi: 10.1016/S2255-4971(15)30428-6. eCollection 2010 Sep-Oct.
To evaluate the presence of pain at the site of the surgical incision and the need to remove the tibial fixation screw in anterior cruciate ligament (ACL) reconstruction, in relation to sex and body mass index (BMI).
A group of 265 patients who underwent ACL reconstruction with ipsilateral flexor tendon grafts from the thigh in which the tibial fixation technique consisted of using a cortical screw and metal washer, between July 2000 and November 2007, were evaluated.
176 patients were evaluated for an average of 33.3 ± 19.5 months; median of 29.5 months; IIQ: 17-45 months; minimum of 8 and maximum of 87 months. There was no statistical difference regarding complaints of pain at the site of the screw (p = 0.272) and the need to remove the tibial screw (p = 0.633) between sexes. There was no statistical difference regarding complaints of pain at the site of the screw (p = 0.08) and the need to remove the tibial screw (p = 0.379) according to BMI.
The pain complaint rate at the screw site from the screw and metal washer method used for tibial fixation in ACL reconstruction was of the order of 25%, and the screw had to be removed in 10.8% of the cases. There was no predominance of pain complaints at the surgical wound between the sexes. There was a greater tendency to complain about pain among patients with BMI < 25. There was no predominance of screw and washer removal between the sexes or between individuals with different BMIs.
评估前交叉韧带（ACL）重建术中手术切口部位疼痛的存在情况以及取出胫骨固定螺钉的必要性，并分析其与性别和体重指数（BMI）的关系。
对2000年7月至2007年11月期间的265例患者进行评估，这些患者采用同侧大腿屈肌腱移植进行ACL重建，胫骨固定技术采用皮质骨螺钉和金属垫圈。
176例患者接受评估，平均时间为33.3±19.5个月；中位数为29.5个月；四分位间距：17 - 45个月；最短8个月，最长87个月。性别之间在螺钉部位疼痛主诉（p = 0.272）和取出胫骨螺钉的必要性（p = 0.633）方面无统计学差异。根据BMI，在螺钉部位疼痛主诉（p = 0.08）和取出胫骨螺钉的必要性（p = 0.379）方面无统计学差异。
ACL重建术中用于胫骨固定的螺钉和金属垫圈方法导致的螺钉部位疼痛主诉率约为25%，10.8%的病例需要取出螺钉。男女在手术伤口疼痛主诉方面无明显差异。BMI < 25的患者更倾向于主诉疼痛。男女之间或不同BMI个体之间在取出螺钉和垫圈方面无明显差异。
