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OBJECTIVES: To investigate the current clinical practice regarding pre- and post-surgical rehabilitation and return to sport (RTS) criteria following anterior cruciate ligament reconstruction (ACLR). DESIGN: Cross-sectional design. Online survey. SETTING: Survey platform. PARTICIPANTS: Argentinian physical therapists (PTs). OUTCOME MEASURES: The survey consisted of a combination of 39 open- and closed-ended questions, divided across 3 sections: (1) demographic and professional information, (2) clinical practice and rehabilitation strategies, and (3) return-to-running (RTR) and RTS. RESULTS: A total of 619 PTs completed the survey. Considerable variability was observed in preoperative rehabilitation, criteria used for rehabilitation progression and RTS decision-making criteria used by PTs. From the total surveyed, 336 (54.3%) carried out RTS assessment in their clinical practice. Most of PTs (53.3%) use visual estimation to assess knee range of motion. Only 20% of the PTs reported incorporating patient-reported outcome measures in their decision-making. From PTs who use strength assessment as a criterion of RTS (68.8%), 16.6% extrapolate this from jump tests and 15.3% use manual muscle testing. Less than the 50% of the PTs recommended nine months or more to allow patients to RTS. CONCLUSIONS: Current rehabilitation practices of Argentinian PTs following ACLR are largely variable and not aligned with current evidence and scientific guidelines. To achieve better rehabilitation and RTS practices better knowledge dissemination and implementation are required.

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BACKGROUND: Rehabilitation following anterior cruciate ligament (ACL) reconstruction surgery is essential to regain functionality and return to previous activity level. Electromyographic biofeedback may be an effective intervention for rehabilitation of patients following ACL surgery. OBJECTIVE: To synthesize the available evidence on the effect of electromyographic biofeedback in the treatment of quadriceps strength following ACL surgery. DESIGN: Systematic review with meta-analysis. DATA SOURCES: PubMed, EMBASE, CENTRAL and Epistemonikos were searched. ELIGIBILITY CRITERIA: Randomized clinical trials with patients undergoing ACL reconstruction surgery comparing biofeedback with a standard rehabilitation control group. DATA EXTRACTION AND DATA SYNTHESIS: Two authors selected articles and performed data extraction. The analysed outcomes were strength, function, pain, knee extension and balance. The risk of bias of individual studies was assessed using the Cochrane Risk of Bias Tool. Results were combined through random-effects meta-analysis, reporting mean differences. RESULTS: Eight articles were included in the qualitative analysis, and four articles were included in the quantitative analysis. The interventions lasted between 4 and 12 weeks. Three studies evaluated the effect of biofeedback on quadriceps strength; of these, two studies showed a significant difference in favour of the biofeedback group. In addition, biofeedback was found to improve knee extension [standardized mean difference - 1.3, 95% confidence interval (CI) - 1.74 to -0.86] and balance (one study). There was no significant difference in Lysholm score (mean difference -6.21, 95% CI -17.51 to 5.08; I2 =59%) or pain between the biofeedback group and the control group. CONCLUSION: Electromyographic biofeedback in knee rehabilitation could be useful following ACL reconstruction surgery. KEY MESSAGES: SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO (CRD42020193768).

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Abstract Objective To compare the effectiveness of the early accelerated rehabilitation and delayed conservative rehabilitation protocols after arthroscopic anterior cruciate ligament reconstruction, in terms of the International Knee Documentation Committee (IKDC) score, pain (according to the Visual Analog Scale), laxity, and stiffness one year postoperatively to determine the best outcome. Materials and Methods A total of 80 subjects were divided into 2e groups (early accelerated group and delayed conservative group), which were analyzed by the Pearson Chi-squared and Wilcoxon rank-sum tests. Results One year postoperatively, knee laxity was significantly higher (p = 0.039) in the early accelerated group compared with the delayed conservative group. Regarding postoperative pain (according to the Visual Analogue Scale) and IKDC scores, both groups presented similar results. The postoperative range of motion was better in the early accelerated group, but this was not statistically significant (p = 0.36). Conclusion One year postoperatively, the early accelerated rehabilitation protocol was associated with significant knee laxity compared to the delayed conservative rehabilitation protocol.

Resumo Objetivo Comparar a eficácia dos protocolos de reabilitação acelerada precoce e de reabilitação conservadora retardada após reconstrução artroscópica do ligamento cruzado anterior, em termos da escala do International Knee Documentation Committee (IKDC), da dor (segundo a Escala Visual Analógica), da frouxidão e da rigidez no pós-operatório de um ano para determinar o melhor desfecho. Materiais e Métodos Um total de 80 participantes foram divididos em dois grupos (grupo da acelerada precoce e grupo da conservadora retardada), que foram analisados pelos testes do Qui-quadrado de Pearson e da soma dos postos de Wilcoxon. Resultados A frouxidão do joelho no pós-operatório de 1 ano foi significativamente mais alta (p = 0,039) no grupo da acelerada precoce do que no grupo da conservadora retardada. Em termos de dor pós-operatória (pela Escala Visual Analógica) e pontuações no IKDC, ambos os grupos apresentaram resultados similares. A amplitude de movimento pós-operatória foi melhor no grupo da acelerada precoce, mas isso não foi estatisticamente significativo (p = 0,36). Conclusão O protocolo de reabilitação acelerada precoce foi associado com uma frouxidão significativa do joelho em um ano de pós-operatório em comparação com o protocolo de reabilitação conservadora retardada.

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ABSTRACT Introduction In long-term sports, especially in explosive sports such as accelerated starting, athletes are prone to rupture the anterior cruciate ligament (ACL). It is the ultimate goal of ACL reconstruction for athletes to restore the stability (static and dynamic) and mechanical structure of the knee joint through reconstruction surgery. Object This article uses ACL reconstruction to repair patients' ACL and explores the effect of athletes' nerve recovery after sports. Methods We collected 35 ACL reconstruction athletes and randomly divided them into two groups (experimental group, 18; control group, 17). After reconstruction, the athletes in the experimental group were treated with sports rehabilitation. Results The experimental and control groups had great differences in knee joint exercise indexes and nerve function recovery. Conclusion Sports rehabilitation training can effectively improve the nerve function of the knee joint after ACL reconstruction. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução Em esportes de longa duração, especialmente em esportes explosivos, como partidas aceleradas, os atletas têm tendência a romper o ligamento cruzado anterior (LCA). O objetivo final da reconstrução do LCA para atletas é restaurar a estabilidade (estática e dinâmica) e a estrutura mecânica da articulação do joelho por meio da cirurgia de reconstrução. Objetivo Este artigo considera a reconstrução do reparo do LCA em pacientes e explora o efeito da recuperação nervosa em atletas após a prática de esportes. Métodos Foram coletados 35 atletas de reconstrução do LCA e os dividimos aleatoriamente em dois grupos (grupo experimental, 18; grupo controle, 17). Após a reconstrução, os atletas do grupo experimental foram tratados com reabilitação esportiva. Resultados Os grupos experimental e controle tiveram grandes diferenças nos índices de exercício da articulação do joelho e recuperação da função nervosa. Conclusão O treinamento de reabilitação esportiva pode efetivamente melhorar a função nervosa da articulação do joelho após a reconstrução do LCA. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción En deportes de larga duración, especialmente en deportes explosivos como la partida acelerada, los deportistas son propensos a romperse el ligamento cruzado anterior (LCA). El objetivo final de la reconstrucción del LCA para los atletas es restaurar la estabilidad (estática y dinámica) y la estructura mecánica de la articulación de la rodilla mediante la cirugía de reconstrucción. Objeto Este artículo considera la reconstrucción para reparar el LCA de los pacientes y explora el efecto de la recuperación nerviosa de los atletas después de los deportes. Métodos Recogimos 35 deportistas de reconstrucción del LCA y los dividimos aleatoriamente en dos grupos (grupo experimental, 18; grupo de control, 17). Después de la reconstrucción, los atletas del grupo experimental fueron tratados con rehabilitación deportiva. Resultados Los grupos experimental y de control tuvieron grandes diferencias en los índices de ejercicio de la articulación de la rodilla y la recuperación de la función nerviosa. Conclusión el entrenamiento de rehabilitación deportiva puede mejorar eficazmente la función nerviosa de la articulación de la rodilla después de la reconstrucción del LCA. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

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El esquí es un deporte individual con una tasa de lesiones de 1,84 por 1.000 días esquiador en la población general. Las roturas del ligamento cruzado anterior (LCA) son algunas de las más comunes, llegando a una tasa de 5 por cada 100 esquiadores por temporada a nivel competitivo, debido a la gran exigencia a la que se encuentran sometidas las rodillas. Lo anterior presenta un desafío para el traumatólogo a la hora de plantear un manejo. Se realizó una revisión de la literatura respecto de los mecanismos de lesión, tratamiento, prevención, rehabilitación y uso de órtesis en el retorno deportivo. Se describen los mecanismos clásicos de lesión en esquiadores amateurs y competitivos. La mayoría de las lesiones de LCA son de resolución quirúrgica, en que la recomendación de reconstrucción debe ser con injerto autólogo de hueso-tendón patelar-hueso, salvo en los pacientes mayores o en pacientes con fisis abierta, en los que se recomienda el uso de injerto autólogo de semitendinoso-gracilis. La prevención y rehabilitación se basan en mejorar la fuerza y el control neuromuscular de los estabilizadores dinámicos de la rodilla implementándose programas específicos, evaluación del gesto deportivo, y pruebas de control neuromuscular. Se recomienda el uso de órtesis funcionales adecuadas en los pacientes sometidos a reconstrucción del LCA. Las lesiones de LCA en esquiadores de nivel competitivo son habituales, de manejo específico y multidisciplinario. La elección del injerto y del tipo de rehabilitación son fundamentales en el retorno deportivo del esquiador. NIVEL DE EVIDENCIA: V.

Skiing is an individual sport with an injury rate of 1.84 per 1,000 skier days among the general population. Anterior cruciate ligament (ACL) tears are among the most common injuries in skiers, with a rate of 5 per 100 skiers per season at a competitive level, because of the great demand placed on the knees. Their treatment is a challenge for orthopedic surgeons. A review of the literature was carried out regarding injury mechanisms, treatment, prevention, rehabilitation, and the use of bracing in the return to sports. The classic injury mechanisms in amateur and competitive skiers are described. Most ACL injuries require surgical resolution, with reconstruction using autologous bone-patellar tendon-bone graft, except in older patients or those with open physis, who must receive an autologous semitendinosusgracilis graft. Prevention and rehabilitation are based on improving strength and neuromuscular control of the dynamic knee stabilizers, implementing specific programs, evaluating the sport movements, and performing neuromuscular control tests. Suitable functional bracings are recommended in patients undergoing ACL reconstruction. ACL injuries in competitive-level skiers are common, and their management is specific and multidisciplinary. The choice of graft and rehabilitation type is critical to resume skiing. LEVEL OF EVIDENCE: V.

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INTRODUCTION: For post-surgical rehabilitation of the anterior cruciate ligament, the medialis and the lateralis vastus need to be worked on for good recovery. There is the discussion about the isometric and isotonic exercises to be used in the rehabilitation phase, and their results diverge in the literature. OBJECTIVE: This study aims to compare the activation of the medialis and the lateralis vastus in isometric and isotonic exercises. METHODS: Eleven subjects (seven men and four women) physically active and experienced in resistance training participated in the study. Anamnesis, anthropometric assessment, 10 Repetition maximum (RM) load test, maximum voluntary isometric contraction test and squat test were performed. RESULTS: For the vastus lateralis of the right leg, the electromyographic activity was significantly higher in the maximal isometric voluntary contraction compared to the dynamic squatting (p<0.05). The same was observed for the left leg (p<0.05). CONCLUSION: Recruitment of the medial and the lateral vastus in isometric exercises is higher in relation to isotonic exercises.

INTRODUÇÃO: Para a reabilitação pós-cirúrgica do ligamento cruzado anterior, os vastos medial e lateral precisam ser trabalhados visando uma boa recuperação. Discute-se a respeito dos exercícios isométricos e isotônicos a serem utilizados na fase de reabilitação, tendo seus resultados divergentes na literatura. OBJETIVO: Assim, o objetivo do presente estudo é comparar a ativação dos vastos medial e lateral em exercícios isométricos e isotônicos. MÉTODOS: Participaram deste estudo 11 sujeitos (sete homens e quatro mulheres), fisicamente ativos e com experiência em musculação. Foi realizada a anamnese, a avaliação antropométrica, o teste de carga de 10 repetições máximas (RM), o teste de contração voluntária isométrica máxima e o teste de agachamento. RESULTADOS: No vasto lateral da coxa direita, a atividade eletromiográfica foi significativamente maior na contração voluntária isométrica máxima em relação ao agachamento dinâmico (p<0,05). O mesmo foi observado na coxa esquerda (p<0,05). CONCLUSÃO: O recrutamento dos vastos medial e lateral em exercícios isométricos é maior em relação a exercícios isotônicos.

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BACKGROUND: One of the most common grafts used to repair anterior cruciate ligament (ACL) rupture is the hamstring tendon (HT) autograft. However, another proposed option to repair the ACL is the quadriceps tendon (QT) autograft. This study aimed to compare the pain and clinical results between patients with ACL injury treated with QT autograft and with HT autograft. MATERIALS AND METHODS: The Ethics and Investigation Committee of our institution approved the study. The patients were randomized into two groups: one group was treated with QT autograft and the other group was treated with HT autograft. The patients were evaluated preoperatively and postoperatively using the Lysholm-Tegner score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and visual analog scale (VAS), at 2 weeks and 1, 3, 6, and 12 months. RESULTS: A total of 28 patients with a primary ACL injury were included in the study. No significant differences in VAS pain, Lysholm knee and Tegner activity scale scores, and IKDC score between the HT and QT groups were observed at any time point. All patients had favorable outcomes and significantly improved evaluation scores. CONCLUSION: The patients treated with QT autograft had clinical results and post-operative pain similar to those of patients treated with HT autograft for ACL reconstruction.

ANTECEDENTES: Uno de los injertos más comúnmente usados para la reparación de una ruptura de ligamento cruzado anterior (LCA) es el autoinjerto de los tendones isquiotibiales. Sin embargo, otra opción propuesta para la reparación del LCA es el autoinjerto del tendón de cuadríceps. El objetivo de este estudio fue comparar el dolor y resultados clínicos en pacientes con lesión del LCA tratados con autoinjerto de cuadríceps y con autoinjerto de isquiotibiales. MATERIAL Y MÉTODOS: El Comité de Ética e Investigación de nuestra institución aprobó el estudio. Los pacientes fueron aleatorizados en dos grupos: un grupo fue tratado con autoinjerto del cuadríceps y el otro grupo con autoinjerto de isquiotibiales. Los pacientes fueron evaluados preoperatoriamente y postoperatoriamente usando la escala de Lysholm-Tegner, la International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, y la Escala Visual Análoga (EVA), a las dos semanas, a 1, 3, 6 y 12 meses. RESULTADOS: Un total de 28 pacientes con lesión primaria de LCA fueron incluidos en el estudio. No hubo diferencias significativas en EVA, escala de Lysholm-Tengner y en IKDC entre los grupos de isquiotibiales y cuadríceps durante su evaluación. Todos los pacientes tuvieron evoluciones favorables y mejoraron de forma significativa sus escalas. CONCLUSIÓN: Los pacientes tratados con autoinjerto de tendón de cuadríceps tuvieron resultados clínicos y dolor postoperatorio similar a aquellos pacientes traídos con autoinjerto de isquiotibiales en la reconstrucción de LCA.

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ABSTRACT Anterior cruciate ligament (ACL) rupture is an injury in young adults, triggering undesirable neuromuscular effects. A rehabilitation program is structured with exercises that aid in intensive care training, and proprioceptive training has been proposed as one of the training/rehabilitation methods in patients undergoing ACL reconstruction. Thus, this study aimed to analyze, through a systematic literature review, the effects of including proprioceptive training on different outcomes (stability/balance, proprioception, strength, functional capacity, coordination) after ACL reconstruction surgery in young adults. The search of the articles included studies in the last ten years, being a search conducted in November 2018. Searches were conducted in the electronic databases of PubMed and Science Direct with a following search methodology: (("Proprioception" [Mesh] ) OR "Proprioception" [Word Text]) AND ("Anterior Cruciate Ligament" [Mesh] OR "Anterior Cruciate Ligament Reconstruction" [Mesh] OR "Anterior Cruciate Ligament Injury" [Mesh]). Six studies were selected for the analysis and the results obtained there is insufficient scientific evidence showing the positive effects of training in proprioceptive training after ACL reconstruction in adults, in view of a shortage of studies, such as discrepancies in findings, without time of intervention and in the tests contracted in the analysis of the variables.

RESUMO A ruptura do ligamento cruzado anterior (LCA) é a lesão de joelho mais frenquente em adultos jovens, desencadeando consequências neuromusculares indesejáveis. Um programa de reabilitação bem estruturado com exercícios que ajudem a minimizar os efeitos deletérios dessas consequências são necessários, e o treinamento proprioceptivo tem sido proposto como um dos métodos de treinamento/reabilitação em pacientes submetidos a reconstrução do LCA. Assim, esse estudo teve como objetivo analisar por meio de revisão sistemática de literatura os efeitos da inclusão do treinamento proprioceptivo sobre diferentes desfechos (estabilidade/equilíbrio, propriocepção, força, capacidade funcional, coordenação) após cirurgia de reconstrução de LCA em adultos jovens. A busca dos artigos incluiu estudos produzidos nos últimos dez anos, sendo a busca realizada no mês de novembro de 2018. Foram conduzidas buscas nas bases de dados eletrônicas PubMed e Science Direct com a seguinte estratégia de busca: (("Proprioception"[Mesh] OR "Proprioception"[Text Word])) AND ("Anterior Cruciate Ligament"[Mesh] OR "Anterior Cruciate Ligament Reconstruction"[Mesh] OR "Anterior Cruciate Ligament Injuries"[Mesh]). Seis estudos foram selecionados para análise e os resultados mostraram que não há evidencias científicas suficientes que mostrem os efeitos positivos da inclusão do treinamento proprioceptivo após cirurgia de reconstrução de LCA em adultos, tendo em vista a escassez de estudos, as discrepâncias nos achados, no tempo de intervenção e nos testes utilizados nas análises das variáveis.

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BACKGROUND: After anterior cruciate ligament (ACL) reconstruction, 63% to 87% of high school athletes return to competition. Although physical and psychological factors are known contributors for failure to return to play, little attention has been paid to effect of academic grade level. Our purpose was to determine the influence of effect of academic grade level on return to competitive play. The primary hypothesis is that high school seniors who undergo ACL reconstruction or knee arthroscopy will be less likely to return to competitive play at 1 year than those in grades 9 to 11. METHODS: We retrospectively reviewed high school athletes who injured their knee during competitive athletic activity and underwent arthroscopic knee surgery, including ACL reconstruction. We included those 14 to 18 years old at time of surgery and analyzed records for grade level, sporting activity, surgery details, and date of return to play. The definition of return to competitive play was return to same preinjury sport within 1 year of surgery and the sport had to be organized. RESULTS: Our study group included 225 patients that underwent an ACL reconstruction and 74 had knee arthroscopy. Athletes undergoing ACL reconstructions were less likely to return to preinjury sport within 1 year than those undergoing knee arthroscopy (P=0.0163). Seniors were significantly less likely to return to play at 1 year than athletes in grades 9 to 11 after both ACL reconstruction (P<0.0001) and knee arthroscopy (P=0.0335). Although return to competitive play rates remained fairly constant within grades 9 to 11, a precipitous decline by 28.9% and 29.4% in return to play rates occurred in the ACL reconstruction and knee arthroscopy groups, respectively, between the junior and senior years of high school. DISCUSSION: Although return to competition rates were lower for high school athletes undergoing ACL reconstruction than those undergoing knee arthroscopy, both had declines in return when the surgery occurs during their senior season. These data are useful when interpreting return to play rates. Future studies would benefit from further defining this relationship, or at least, noting the number of "senior" athletes studied. LEVEL OF EVIDENCE: Therapeutic study-Level III.

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BACKGROUND: A direct blow to the knee is one way to injure the anterior cruciate ligament (ACL), e.g., during a football or traffic accident. Robot-assisted therapy (RAT) rehabilitation, simulating regular walking, improves walking and balance abilities, and extensor strength after ACL reconstruction. However, there is a need to perform RAT during other phases of ACL injury rehabilitation before attempting an advanced exercise such as walking. This paper aims to propose a myoelectric control (MEC) algorithm for a robot-assisted rehabilitation system, "Nukawa", to assist knee movement during these types of exercises, i.e., such as in active-assisted extension exercises. METHODS: Surface electromyography (sEMG) signal processing algorithm was developed to detect the motion intention of the knee joint. The sEMG signal processing algorithm and the movement control algorithm, reported by the authors in a previous publication, were joined together as a hardware-in-the-loop simulation to create and test the MEC algorithm, instead of using the actual robot. EXPERIMENTS AND RESULTS: An experimental protocol was conducted with 17 healthy subjects to acquire sEMG signals and their lower limb kinematics during 12 ACL rehabilitation exercises. The proposed motion intention algorithm detected the orientation of the intention 100% of the times for the extension and flexion exercises. Also, it detected in 94% and 59% of the cases the intensity of the movement intention in a comparable way to the maximum voluntary contraction (MVC) during extension exercises and flexion exercises, respectively. The maximum position mean absolute error was [Formula: see text], [Formula: see text], and [Formula: see text] for the hip, knee, and ankle joints, respectively. CONCLUSIONS: The MEC algorithm detected the intensity of the movement intention, approximately, in a comparable way to the MVC and the orientation. Moreover, it requires no prior training or additional torque sensors. Also, it controls the speed of the knee joint of Nukawa to assist the knee movement, i.e., such as in active-assisted extension exercises.

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INTRODUCTION: The simultaneous rupture of anterior cruciate ligament (ACL) and patellar ligament (PL) is an infrequent condition. Each isolated injury has surgical techniques and rehabilitation protocols that differ widely among each other. Nonetheless, there is no established physical rehabilitation approach when both injuries are associated. OBJECTIVE: The aim of this report is to describe the rehabilitation and the outcomes obtained in the postoperative period of simultaneous rupture of ACL and PL and the follow-up period. CASE REPORT: A 21-year-old male patient suffered the rupture of ACL and PL after landing from a jump while playing soccer. The knee was immediately immobilized, and 10 weeks later, he was operated in a one-stage surgery. He initiated his rehabilitation 3 weeks after the surgical resolution. A three-times a week rehabilitation was implemented to restore range of motion and improve functional status. An extensive evaluation was carried out monthly using dynamic neuromuscular tests and self-reported questionnaires. RESULTS: At the end of the rehabilitation, he presented a complete extension and 130° of knee flexion in passive open kinetic chain. The Single Leg Squat and Landing Error Scoring System showed a good performance, while the Star Excursion Balance Test and the single hops assessments were symmetrical. The International Knee Documentation Committee and Lower Extremity Functional Scale questionnaires yielded values of 90.8% and 77 points, respectively. CONCLUSION: An approach based on mobility exercises and strengthening of the lower limbs and the core muscles, considering the biological healing times of each particular structure, made it possible to obtain satisfactory results in mobility, functional tests, self-reported questionnaires, and patient's satisfaction.

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This work presents the steps for developing a serious game that allows the interaction through natural gestures, whose main purpose is to contribute to the treatment of individuals who have suffered an injury to the anterior cruciate ligament (ACL). In addition to the serious game development process, the users' gaming experience were performed. Through the evaluation assessment, positive results were obtained in relation to various aspects of the game engagement, proving the playful factor of this activity.

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As Rupturas do ligamento cruzado cranial (RLCCr) são as afecções mais comuns nos joelhos dos cães, que podem ocorrer devido lesões agudas (traumáticas), ou crônicas (degenerativas) no ligamento. Os sinais clínicos são normalmente claudicação, e no exame físico, em 90 % dos casos é possível a confirmação através de teste positivo de gaveta cranial e teste de compressão tibial. Outros meios para se chegar ao diagnóstico da doença é através de exames de imagem. Para o tratamento são citados métodos conservadores e cirúrgicos.Uma das técnicas cirúrgicas citadas atualmente é o Avanço da Tuberosidade Tibial (TTA), que propõe através da osteotomia com avanço cranial da tuberosidade tibial, mantendo-a na posição por um CAGE, placas e parafusos,e assim deixando o ligamento patelar perpendicular ao platô tibial, eliminando com isso o avanço cranial dinâmico do platô tibial. O presente estudo tem como objetivo relatar a evolução clínica e radiográfica de um cão da raça Pit Bull, que foi submetido à técnica de TTA há um ano. É possível avaliar através dos resultados clínicos e radiográficos que a evolução após o procedimento cirúrgico foi satisfatória, tanto na formação de calo ósseo na região da osteotomia, quanto na recuperação física do animal, sem grande evolução da osteoartrite. Conclui-se então que a TTA é atualmente a técnica que obtém melhor resultado no tratamento de RLCCr em cães de raças de grande porte, porém, por ser uma técnica relativamente nova, ainda é de custo elevado e necessita de mais estudos para sua aplicação na rotina cirúrgica.

The rupture of the cranial cruciate ligament (RLCCr) is the most common disease in the dogs' knee,it can be a result of acute or chronic lesions. The clinic signs are usually lameness, and in the physical test, in 90% of the cases, it is possible to confirm it with cranial drawer tests and tibial compression tests. Another way to diagnosticate the disease is through image tests. Conservative and surgical methods are cited as a treatment.One of the surgical techniques cited is the Tibial Tuberosity Advancement (TTA), that suggests, through the osteotomy - advancement of the cranial tuberosity, keeping it in the position with a CAGE, plates and screws,living the ligament perpendicular to the tibial plateau, avoiding the advancement of the dynamic cranial of the tibial plateau. This study aims to report the clinical and radiographic evolution of a Pit Bull dog submitted to TTA technique a year ago. It is possible evaluate through clinical and radiographic tests that the evolution after the surgery was satisfactory, both in formation of the callus in the area of the osteotomy and in the physical recovery,stopping the development of the osteoarthritis. It is possible to conclude so that the TTA is, nowadays, the technique that presents the best results in the RLLCr treatment in big dogs, however, it is a new technique and because of that its cost is still high and so, it is necessary more studies about its application in the surgery routine.

Las rupturas del ligamento cruzado craneal (RLCCr) son las enfermedades más comunes en las rodillas de los perros, que ocurren por una lesión aguda (traumática) o ligamento crónica (degenerativa). Los síntomas clínicos generalmente son cojera, y el examen físico en el 90% de los casos es posible confirmar mediante pruebas de cajón craneal positivo y prueba de compresión tibial, otros medios para llegar al diagnóstico de la enfermedad es a través de imágenes. Para el tratamiento se citan los métodos conservadores y quirúrgicos.Una de las técnicas quirúrgica mencionadas es la Avance de la Tuberosidad Tibial (TTA) , que propone por osteotomía craneal, avance de la tuberosidad tibial, manteniéndolo en posición con una CAGE, placas y tornillos,dejándolo el ligamento rotuliano perpendicular a la meseta tibial, eliminando de este modo el avance dinámico de la meseta tibial craneal. Este estudio tiene como objetivo informar la evaluación clínica y radiográfica de un perro de raza Pit Bull que se sometió a la técnica TTA hace un año. Es posible evaluar a través de los resultados clínicos y radiográficos que la evolución después de la cirugía fue satisfactoria, tanto en la forrnación de callo en el lugar de la osteotomía, como la recuperación física del animal sin mayor evolución de la osteoartritis. Se concluyó que el TTA es actualmente la técnica que obtiene mejores resultados en el tratamiento de perros RLCCr en las razas grandes, sin embargo, ser una técnica relativamente nueva, todavía es costoso y requiere más estudio para su aplicación en la rutina quirúrgica.

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As Rupturas do ligamento cruzado cranial (RLCCr) são as afecções mais comuns nos joelhos dos cães, que podem ocorrer devido lesões agudas (traumáticas), ou crônicas (degenerativas) no ligamento. Os sinais clínicos são normalmente claudicação, e no exame físico, em 90 % dos casos é possível a confirmação através de teste positivo de gaveta cranial e teste de compressão tibial. Outros meios para se chegar ao diagnóstico da doença é através de exames de imagem. Para o tratamento são citados métodos conservadores e cirúrgicos.Uma das técnicas cirúrgicas citadas atualmente é o Avanço da Tuberosidade Tibial (TTA), que propõe através da osteotomia com avanço cranial da tuberosidade tibial, mantendo-a na posição por um CAGE, placas e parafusos,e assim deixando o ligamento patelar perpendicular ao platô tibial, eliminando com isso o avanço cranial dinâmico do platô tibial. O presente estudo tem como objetivo relatar a evolução clínica e radiográfica de um cão da raça Pit Bull, que foi submetido à técnica de TTA há um ano. É possível avaliar através dos resultados clínicos e radiográficos que a evolução após o procedimento cirúrgico foi satisfatória, tanto na formação de calo ósseo na região da osteotomia, quanto na recuperação física do animal, sem grande evolução da osteoartrite. Conclui-se então que a TTA é atualmente a técnica que obtém melhor resultado no tratamento de RLCCr em cães de raças de grande porte, porém, por ser uma técnica relativamente nova, ainda é de custo elevado e necessita de mais estudos para sua aplicação na rotina cirúrgica.(AU)

The rupture of the cranial cruciate ligament (RLCCr) is the most common disease in the dogs' knee,it can be a result of acute or chronic lesions. The clinic signs are usually lameness, and in the physical test, in 90% of the cases, it is possible to confirm it with cranial drawer tests and tibial compression tests. Another way to diagnosticate the disease is through image tests. Conservative and surgical methods are cited as a treatment.One of the surgical techniques cited is the Tibial Tuberosity Advancement (TTA), that suggests, through the osteotomy - advancement of the cranial tuberosity, keeping it in the position with a CAGE, plates and screws,living the ligament perpendicular to the tibial plateau, avoiding the advancement of the dynamic cranial of the tibial plateau. This study aims to report the clinical and radiographic evolution of a Pit Bull dog submitted to TTA technique a year ago. It is possible evaluate through clinical and radiographic tests that the evolution after the surgery was satisfactory, both in formation of the callus in the area of the osteotomy and in the physical recovery,stopping the development of the osteoarthritis. It is possible to conclude so that the TTA is, nowadays, the technique that presents the best results in the RLLCr treatment in big dogs, however, it is a new technique and because of that its cost is still high and so, it is necessary more studies about its application in the surgery routine.(AU)

Las rupturas del ligamento cruzado craneal (RLCCr) son las enfermedades más comunes en las rodillas de los perros, que ocurren por una lesión aguda (traumática) o ligamento crónica (degenerativa). Los síntomas clínicos generalmente son cojera, y el examen físico en el 90% de los casos es posible confirmar mediante pruebas de cajón craneal positivo y prueba de compresión tibial, otros medios para llegar al diagnóstico de la enfermedad es a través de imágenes. Para el tratamiento se citan los métodos conservadores y quirúrgicos.Una de las técnicas quirúrgica mencionadas es la Avance de la Tuberosidad Tibial (TTA) , que propone por osteotomía craneal, avance de la tuberosidad tibial, manteniéndolo en posición con una CAGE, placas y tornillos,dejándolo el ligamento rotuliano perpendicular a la meseta tibial, eliminando de este modo el avance dinámico de la meseta tibial craneal. Este estudio tiene como objetivo informar la evaluación clínica y radiográfica de un perro de raza Pit Bull que se sometió a la técnica TTA hace un año. Es posible evaluar a través de los resultados clínicos y radiográficos que la evolución después de la cirugía fue satisfactoria, tanto en la forrnación de callo en el lugar de la osteotomía, como la recuperación física del animal sin mayor evolución de la osteoartritis. Se concluyó que el TTA es actualmente la técnica que obtiene mejores resultados en el tratamiento de perros RLCCr en las razas grandes, sin embargo, ser una técnica relativamente nueva, todavía es costoso y requiere más estudio para su aplicación en la rutina quirúrgica.(AU)

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