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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(01): e68-e75
DOI: 10.1055/s-0044-1779685
Artigo Original
Joelho

Análise funcional e isocinética comparativa entre implantes com estabilização posterior e rotatórios constritos (hinge) em artroplastias do joelho

Article in several languages: português | English
Sandra Tie Nishibe Minamoto 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Alan de Paula Mozella 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Victor Rodrigues Amaral Cossich 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Ubiratã Faleiro Gavilão 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
Heitor Schuabb Machado 
1   Centro de Cirurgia do Joelho do Instituto Nacional de Traumatologia e Ortopedia. Rio de Janeiro, RJ, Brasil
,
João Maurício Barretto 
2   Grupo de Joelho do Hospital São Vicente, Rede D'Or, Rio de Janeiro, RJ, Brasil
› Author Affiliations Suporte Financeiro Não houve suporte financeiro de fontes públicas, comerciais, ou sem fins lucrativos.
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Resumo

Objetivo: Comparar a função e a força muscular do membro entre pacientes submetidos a artroplastias do joelho que utilizaram implantes primários com estabilização posterior (grupo controle) e pacientes com implantes constritos rotatórios (grupo Hinge).

Métodos: A avaliação da função foi feita por meio do Knee Society Score (KSS) e da força muscular por um dinamômetro isocinético utilizando a velocidade de 60°/s.

Resultados: Foram analisados 43 pacientes, que realizaram 51 cirurgias, sendo o grupo Hinge composto por 25 cirurgias e o grupo controle por 26 cirurgias primárias. Não observamos diferenças significativas entre os grupos Hinge e controle nos valores do KSS funcional (p = 0,54), KSS objetivo (p = 0,91), pico de torque flexor (p = 0,25) e pico de torque extensor (p = 0,08). Os pacientes do grupo Hinge que realizaram artroplastias primárias apresentaram um pico de torque flexor maior (0,76 Nm/kg) que aqueles que utilizaram o implante em revisão após falha séptica (0,33 Nm/kg) (p < 0,05). O implante constrito foi indicado em cirurgias de revisão de artroplastia com instabilidade ligamentar grave e em casos de artroplastias primárias complexas com destruição óssea ou deformidade coronal grave no plano coronal.

Conclusão: O uso de implantes bloqueados possibilita função articular e força muscular comparáveis a dos pacientes que realizaram artroplastia primária utilizando implantes convencionais com estabilização posterior. Pacientes submetidos à revisão séptica com prótese Hinge rotatória apresentam menor força da musculatura flexora em relação àqueles submetidos a artroplastia primária com implante constrito.

Palavras-chave

artroplastia do joelho - osteoartrite do joelho - força muscular

Trabalho desenvolvido no INTO – Instituto Nacional de Traumatologia e Ortopedia Rio de Janeiro, RJ, Brasil.




Publication History

Received: 23 November 2021

Accepted: 26 June 2023

Article published online:
21 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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