RESUMO
La actividad deportiva en niños y adolescentes ha presentado un aumento sostenido en nuestro país en los últimos años; esto ha generado un aumento de las lesiones deportivas por sobreuso. Éstas pueden tener múltiples orígenes, dependiendo de la edad y la actividad del paciente. La mayoría son de manejo conservador, sin embargo, algunas requieren manejo quirúrgico. Lo más importante es la prevención de estas lesiones mediante el uso de equipo apropiado, regulando la intensidad y tipo de entrenamiento y tratando precozmente las lesiones.
Sports activity in children and adolescents has presented a sustained increase in our country in recent years, generating an increase in sports-related overuse injuries. These injuries vary in nature, depending on the patient Ìs age and level of training. Most are conservatively managed; although, some will require surgical treatment. It is important, however, to try to prevent these injuries by using appropriate equipment, regulating the intensity and type of training and treating injuries early
Assuntos
Humanos , Criança , Adolescente , Transtornos Traumáticos Cumulativos/diagnóstico , Transtornos Traumáticos Cumulativos/fisiopatologia , Transtornos Traumáticos Cumulativos/terapia , Transtornos Traumáticos Cumulativos/prevenção & controleRESUMO
PURPOSE: The purpose of this study was to determine if the use of platelet concentrate (PC) and bone plug (BP) does accelerate the healing process in anterior cruciate ligament (ACL) reconstruction. METHODS: One hundred and eight patients requiring ACL reconstruction were prospectively randomized into 4 groups: control (27 patients), PC (26 patients), BP (28 patients), and a combination of PC and BP (27 patients). Magnetic resonance imaging (MRI) studies were carried out at both 3 and 6 months postsurgery. Maturation of the graft was evaluated at the femoral tunnel using MRI maturation criteria defined by a low-intensity signal, absence of osteoligamentous interface, and no widening of the femoral tunnel. RESULTS: Three months after surgery, no differences were found among the groups regarding MRI maturation criteria. Six months postsurgery, 78% of the patients in the control group had a low-intensity signal, while in the PC group the low-intensity signal was present in 100% of the patients (P = .036). No statistical differences were observed regarding the osteoligamentous interface between the various groups. Finally, tunnel widening was seen in 11% of the patients of the BP group versus 41% of the patients in the control group (P = .047), but no statistical difference was seen with the other groups. CONCLUSIONS: The use of PC had an enhancing effect on the graft maturation process evaluated only by MRI signal intensity, without showing any significant effect in the osteoligamentous interface or tunnel widening evolution. The use of a BP effectively prevented tunnel widening. The BP and PC combination did not show a synergic effect as compared to PC or BP individually. LEVEL OF EVIDENCE: Level II, lesser quality randomized controlled trial.