Treatment of chronic patellar ligament lesion with autograft and v-y quadricepsplasty / Tratamento da lesão crônica do ligamento patelar com enxerto autológo e quadricepsplastia em V-Y

OBJECTIVE: Review of the literature concerning the subject and to compare the results of the technique we have been using with the ones reported on the literature. METHODS: This is a retrospective, cross-sectional and observational study. We evaluated the records of patients treated surgically at the Hospital from Hospital Maria Amelia Lins January 1997 to January 2011.The following variables were considered: age, gender, side, degree of injury, mechanism of trauma, associated injuries, time elapsed between injury and surgical procedure, complications, range of motion and muscle strength. RESULTS: Five patients underwent surgical treatment with the use of autograft semitendinosus and gracilis tendons and V-Y quadricepsplasty. Regarding gender, there was a male predominance (80%). The average age was 35.2 years old. The right side was the most affected (60%). The predominant mechanism of injury was motorcycle accident (80%). All patients had a complete tendon lesion. Time between injury and surgery averaged 10.4 months. Four patients (80%) had had associated injuries. In all patients muscle strength was satisfactory (M4/M5). Wound dehiscence was observed in 01 patient. Average postoperative range of motion was 110°. CONCLUSIONS: These are rare lesions. Stretching the quadriceps is essential to decrease the tension to the reconstructed patellar ligament and patellofemoral joint. Use of a quadriceps transtendon tunnel is an option to prevent fractures. Hypotrophy of the quadriceps is inevitable, however, the resulting force is sufficient for daily ...

OBJETIVO: Fazer revisão da literatura pertinente ao tema e comparar os resultados da técnica por nós usada com as vigentes na literatura atual. MÉTODOS : Trata-se de estudo retrospectivo, transversal e observacional. Avaliaram-se os prontuários dos pacientes tratados cirurgicamente no Hospital Maria Amélia Lins de janeiro de 1997 a janeiro de 2011. As seguintes variáveis foram consideradas: idade, gênero, lado, grau da lesão, mecanismo de trauma, lesões associadas, tempo transcorrido entre a lesão e o procedimento cirúrgico, complicações, amplitude de movimento e força muscular. RESULTADOS : Cinco pacientes foram submetidos a tratamento cirúrgico com o uso de autoenxerto (ou enxerto autólogo) de tendões semitendíneo e grácil associado à quadricepsplastia em V-Y. Com relação ao gênero, houve predominância do masculino (80%). A faixa etária média foi de 35,2 anos. O lado mais acometido foi o direito (60%). O mecanismo de lesão predominante foi acidente motociclístico (80%). Todos os pacientes apresentaram lesão completa do ligamento patelar. O tempo transcorrido entre a lesão e a cirurgia foi, em média, de 10,4 meses. Quatro pacientes (80%) apresentaram lesões associadas. Em todos os pacientes a força muscular foi considerada satisfatória (m4/m5). Deiscência da ferida foi observada em um paciente. A amplitude de movimento média pós- operatória foi de 110º. CONCLUSÕES : São lesões raras. ...

Treatment of chronic patellar ligament lesion with autograft and v-y quadricepsplasty.

OBJECTIVE: Review of the literature concerning the subject and to compare the results of the technique we have been using with the ones reported on the literature. METHODS: This is a retrospective, cross-sectional and observational study. We evaluated the records of patients treated surgically at the Hospital from Hospital Maria Amelia Lins January 1997 to January 2011.The following variables were considered: age, gender, side, degree of injury, mechanism of trauma, associated injuries, time elapsed between injury and surgical procedure, complications, range of motion and muscle strength. RESULTS: Five patients underwent surgical treatment with the use of autograft semitendinosus and gracilis tendons and V-Y quadricepsplasty. Regarding gender, there was a male predominance (80%). The average age was 35.2 years old. The right side was the most affected (60%). The predominant mechanism of injury was motorcycle accident (80%). All patients had a complete tendon lesion. Time between injury and surgery averaged 10.4 months. Four patients (80%) had had associated injuries. In all patients muscle strength was satisfactory (M4/M5). Wound dehiscence was observed in 01 patient. Average postoperative range of motion was 110°. CONCLUSIONS: These are rare lesions. Stretching the quadriceps is essential to decrease the tension to the reconstructed patellar ligament and patellofemoral joint. Use of a quadriceps transtendon tunnel is an option to prevent fractures. Hypotrophy of the quadriceps is inevitable, however, the resulting force is sufficient for daily living activities.