PATELLAR FRACTURE IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: IN VITRO ANALYSIS.

IF 0.5 4区医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI:10.1590/1413-785220233102e259557

Marcelo DE Almeida Ferrer, Mariana DE Oliveira Lobo, Laís Maria Pinto Almeida, Anderson Freitas, Sílvio Leite DE Macedo Neto, Leonardo Morais Paiva, Leonardo Rigobello Battaglion

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Abstract

Objective: To determine, by biomechanical analysis, safe patellar cut limits in anterior cruciate ligament (ACL) reconstruction that minimize fracture risks.

Methods: From three-dimensional reconstruction, triangular cuts were made in the patella, with a depth of 6.5 mm and variable width and length (10 to 20 mm and 8 to 12 mm, respectively, both with an interval of 1 mm). The combinations of cuts constituted 55 models for tests, with five variations in width and 11 variations in length, tested with the finite element method (FEM).

Results: The mean of the localized principal maximum (traction force) values was 4.36 Pa (SD 0.87 ± 0.76) and the localized principal minimum (compression force) was -4.33 Pa (SD 1.05 ± 1.11). Comparing width and length to the tension force of the values of the main maximum, we found statistical significance from 11 mm for width and 13 mm for length.

Conclusion: In ACL reconstruction, the removal of the patellar bone fragment is safe for fragments smaller than 11 mm in width and 13 mm in length, which corresponds to 24% of the width and 28% of the length of the patella used. Level of Evidence II, Comparative Prospective Study.

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前交叉韧带重建髌骨骨折:体外分析。

目的:通过生物力学分析，确定前交叉韧带(ACL)重建中安全的髌骨切面范围，以减少骨折风险。方法:从三维重建出发，在髌骨处做三角形切口，切口深度为6.5 mm，宽度和长度分别为10 ~ 20mm和8 ~ 12mm，间隔均为1mm。这些切割组合构成了55个用于测试的模型，其中宽度有5个变化，长度有11个变化，并采用有限元法进行了测试。结果:局部主最大值(牵引力)平均值为4.36 Pa (SD 0.87±0.76)，局部主最小值(压缩力)平均值为-4.33 Pa (SD 1.05±1.11)。比较宽度和长度对拉力的主要最大值的值，我们发现从宽度11 mm到长度13 mm有统计学意义。结论:在ACL重建中，对于宽度小于11 mm、长度小于13 mm的碎片，即所使用髌骨宽度的24%和长度的28%，髌骨碎片的移除是安全的。证据水平II，比较前瞻性研究。

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来源期刊

Acta Ortopedica Brasileira Orthopedics-

CiteScore

0.90

自引率

14.30%

发文量

审稿时长

25 weeks

期刊介绍： A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.