Cury Ricardo de Paula Leite, Sprey Jan Willem Cerf, Bragatto André Luiz Lima, Mansano Marcelo Valentim, Moscovici Herman Fabian, Guglielmetti Luiz Gabriel Betoni
Faculdade de Ciências Médicas da Santa Casa de Misericórdia de São Paulo, Departamento de Ortopedia e Traumatologia, Grupo de Cirurgia de Joelho, São Paulo, SP, Brazil.
Rev Bras Ortop. 2017 May 10;52(3):319-324. doi: 10.1016/j.rboe.2017.05.003. eCollection 2017 May-Jun.
To compare the clinical results of the reconstruction of the anterior cruciate ligament by transtibial, transportal, and outside-in techniques.
This was a retrospective study on 90 patients (ACL reconstruction with autologous flexor tendons) operated between August 2009 and June 2012, by the medial transportal (30), transtibial (30), and "outside-in" (30) techniques. The following parameters were assessed: objective and subjective IKDC, Lysholm, KT1000, Lachman test, Pivot-Shift and anterior drawer test.
On physical examination, the Lachman test and Pivot-Shift indicated a slight superiority of the outside-in technique, but without statistical significance ( = 0.132 and = 0.186 respectively). The anterior drawer, KT1000, subjective IKDC, Lysholm, and objective IKDC tests showed similar results in the groups studied. A higher number of complications were observed in the medial transportal technique ( = 0.033).
There were no statistically significant differences in the clinical results of patients undergoing reconstruction of the anterior cruciate ligament by transtibial, medial transportal, and outside-in techniques.
比较经胫骨、经隧道和由外向内技术重建前交叉韧带的临床效果。
这是一项对2009年8月至2012年6月间采用内侧经隧道技术（30例）、经胫骨技术（30例）和“由外向内”技术（30例）进行自体屈肌腱前交叉韧带重建手术的90例患者的回顾性研究。评估了以下参数：客观和主观国际膝关节文献委员会（IKDC）评分、Lysholm评分、KT1000测量、拉赫曼试验、轴移试验和前抽屉试验。
体格检查时，拉赫曼试验和轴移试验显示由外向内技术略具优势，但无统计学意义（分别为P = 0.132和P = 0.186）。前抽屉试验、KT1000测量、主观IKDC评分、Lysholm评分和客观IKDC评分在各研究组中结果相似。内侧经隧道技术中观察到的并发症数量更多（P = 0.033）。
采用经胫骨、内侧经隧道和由外向内技术重建前交叉韧带的患者，其临床效果无统计学显著差异。
