Abstract
The purpose of this study was to evaluate the existence of differences in the rehabilitation of patients after ACL reconstruction using bone-patellar tendon-bone graft and the four-strand semitendinosus and gracilis tendon grafts, through a literature revision. The researched databases were MEDLINE, EMBASE, LILACS, COCHRANE and PEDro. The inclusion criteria were published studies with methodology draw from randomized clinical trials with or without meta-analysis, individuals with ACL injury, associated or not to meniscal injury, submitted to ligamentoplasty using the bone-patellar tendon-bone graft and the four-strand semitendinosus and gracilis tendon grafts and physiotherapy; clinical trials comparing the differences in the rehabilitation of these patients, in Portuguese, English and Spanish, from 1990 to June, 2011. Five clinical trials were reviewed. No difference was observed between the techniques, however, with a recommendation for a less aggressive rehabilitation and greater attention to the strengthening of the hamstring when they are used as grafts.
Highlights
The decision to reconstruct the anterior cruciate ligament (ACL) is based on factors such as: degree of instability, age of patient, knee solicitation level, presence of buckling, recurrent meniscal injuries and interest in returning to sport.[1,2] The goal of the surgery is to create a replica of the original ligament, yet a rehabilitation program is required to obtain the same functional capacities compared to the non-operated limb
Based on the foregoing, the objective of this study was to identify and analyze the content of published scientific articles that verify evolution in the functional recovery of individuals submitted to ACL reconstruction using the BTB or four-strand semitendinous and gracilis tendon graft (FSSG) graft, and that compare whether there is a difference in rehabilitation between the two techniques
Before locating the studies the participants defined the survey question: “Is there a difference in evolution in the rehabilitation of patients submitted to ACL ligamentoplasty with BTB and FSSG graft?” To identify the studies the databases used were: MEDLINE, EMBASE, LILACS, COCHRANE and PEDro
Summary
The decision to reconstruct the anterior cruciate ligament (ACL) is based on factors such as: degree of instability, age of patient, knee solicitation level, presence of buckling, recurrent meniscal injuries and interest in returning to sport.[1,2] The goal of the surgery is to create a replica of the original ligament, yet a rehabilitation program is required to obtain the same functional capacities compared to the non-operated limb. Many studies published in recent years describe the different grafting techniques and options for ACL reconstruction. The BTB autograft presents high resistance, good fixation quality, easy material obtainment,[4] good healing potential, good long-term stability and better rate of return to sport, besides being a fast reconstruction and allowing more aggressive rehabilitation.[5] But there are complications, such as patellar fractures, patellar tendonitis, patellar tendon tear, sensitivity disorders, inability to kneel and pain in the anterior region of the knee.[4]
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