É possivel ter funcionalidade após reconstrução das lesões multiligamentares do joelho?

Abstract

Backgroud: Multilateral Knee Injuries (CML) cause functional changes and a high risk of long-term disability. This study has as its primary objective to evaluate functionality, muscle strength and dynamic balance in patients undergoing CML surgical reconstructions. Secondarily, correlate the muscle strength of the knee stabilizers with the functional tests. Methods: Cross-sectional study, approved by the Ethics Committee and Research with Human Beings of the Federal University of Sergipe (CAAE: 13630519.5.0000.5546). The subjective assessment was composed by the Lysholm and International Knee Documentation Committee (IKDC) questionnaires and the Tampa Scale for Kinesiophobia (TSK). Objectively, the functional tests of the jump, the muscular strength of the knee flexors and extensors were performed using the isokinetic dynamometer; and dynamic balance using the Star Balance Excursion Test (SBET). Results: Twenty-three volunteers were evaluated it was observed according to the excellent, good, fair or poor classification that most of them had poor functionality scores, being 43.5% in the Lysholm questionnaire and 52.2% in the IKDC questionnaire. In addition, in TSK there was a moderate and severe intensity of fear to perform the movement in 60.86% and 17.39% of participants, respectively. Regarding the objective evaluation, a significant difference was observed between the limbs with reduced dynamic balance in the operated limb (p: 0.03). In functional tests, 87% of volunteers failed and only 13% of participants passed all jump tests. Regarding muscle strength, there was a significant difference with lower strength in the operated limb, flexor (p:0.009) and knee extensor muscles compared to the non-operated limb (p: 0.01). In addition, a strong correlation was observed between knee extensor strength and single jump tests (r: 0.75; p: 0.001), triple (r: 0.77; p: 0.001), cross (r: 0.72; p: 0.002) and timed (r: -0.68; p: 0.05). There was a strong correlation of knee flexor strength with cross (r: 0.74; p: 0.002 *) and triple (r: 0.64; p: 0.009) tests and moderate correlation with timed tests (r: -0.45; p: 0.03) and simple (r: 0.45; p: 0.08). Conclusion: Patients submitted to surgical reconstruction after CML present reduced functionality in the operated limb characterized by poor performance in functional jump tests, knee flexion and extension muscle strength deficit, fear of movement and lower subjective function.