Análise dos efeitos agudos e tardios da cirurgia de reconstrução do ligamento cruzado anterior com tendão flexor na cinemática, ativação muscular, equilíbrio e funcionalidade subjetiva dos membros inferiores

Abstract

Rupture of the anterior cruciate ligament (ACL) has been increasingly common in recreational and high-performance sports. There are numerous techniques that have been developed for ACL reconstruction, all of them with their positive and negative points, among them the technique with autologous graft from the medial third of the patellar tendon, and the technique with autologous graft from the tendon of the flexor muscles of the knee, more specifically the gracilis and semitendinosus muscles. Despite an abundant literature on ACL reconstruction surgery and its results, there are few data directly comparing the acute effects of both surgical techniques in terms of electromyography, especially of the proximal hip musculature, lower limb kinematics and their functionality . The aim of study 1 was to investigate acute kinematic changes, body balance strategies and weight distribution in operated and non-operated limbs in the short-term follow-up, in the postoperative period (15 days). Study 2 aimed to investigate the immediate or acute effects of ACL reconstruction on lower limb muscle activation. The aim of study 3 was to investigate kinematic, electromyographic, balance and subjective functional changes in the 3-month period after surgery to reconstruct the anterior cruciate ligament. Simultaneous assessment of three-dimensional kinematics, electromyography and balance of the lower limbs in bipedal support (by baropodometry) was performed during the mini-squat with eyes open and closed, at three times: pre- and postoperatively (15 days and 3 months). The results of these studies indicate that after the ACL injury and subsequent surgical reconstruction, important biomechanical changes are found in the lower limbs, both in the hip joint and in the knee joint, in the operated limb and in the non-operated limb. And throughout the rehabilitation process, an improvement in the movement pattern, improvement in muscle activation, improved balance, less weight distribution in the operated limb and an improvement in the subjective function and symptomatology of the knee were demonstrated.