Objective To evaluate and compare the biomechanical behavior of two different suture configurations:“X”and“Loop”in the preparation of tendons for knee ligament reconstruction. Methods We used common digital extensor tendons of bovine that can replace the human flexor tendons in experimental studies of traction. In the first group, point “X” suture with Ethibond ® No. 5 began in the distal graft points transfixing, with spacing of 7.5 mm points to reach 03 cm distal to the beginning of the suture, returning suture in the same manner, transfixing the tendon in open spaces across the suture configuration “X”. The second group, the point “Loop” was prepared with the same type Ethibond ® No. 5 of the needle wire was removed for use only of the wire was mounted in a twofold manner in a single piece forming a needle loop. Started the suture 3 cm from the end of the graft through loops and transfixing points throughout the tendon substance, with spacing between dots of 7.5 mm. Result The Maximum Force of Rupture suture in “Loop” was 444.45 N and the suture in “X” was 407.59 N with statistical significance (p = 0.030). The average Tension obtained at the suture in “Loop” was 27.67 MPa and at the suture in “X” was 25.73 MPa with a statistically significant difference (p = 0.036). The stiffness showed no statistical differences (p = 0.350) at 11.804 N / mm at the point where “Loop” and 11.570 N / mm at the suture “X”. Conclusion The suture in “Loop” had a higher biomechanical behavior to the suture “X”, considering the Maximum Force and Tension.

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RESUMOA hemofilia é uma doença de herança genética ligada ao cromossomo X. A principal alteração dessa patologia afeta os mecanismos de coagulação. As articulações mais acometidas são os joelhos, cotovelos e tornozelos. As manifestações clínicas incluem dor, sangramento articular e limitação do movimento. O diagnóstico leva em consideração o quadro clínico e exames de imagem. Neste artigo, apresentamos o caso de um paciente com restrição das atividades diárias e perda da qualidade de vida devido à artropatia hemofílica no tornozelo direito. Após a realização da artroplastia total da articulação afetada, o paciente evoluiu com melhora dos parâmetros pré-operatórios. Nível V de Evidência; Opinião de Especialista.Descritores: Tornozelo; Hemofilia; Hemartrose/cirurgia; Artroplastia de substituição do tornozelo. AbStRActHemophilia is a genetically inherited disease linked to the X chromosome. The main alteration of this pathology affects the coagulation mechanisms. The most affected joints are the knees, elbows and ankles. Clinical manifestations include pain, joint bleeding and limited movement. The diagnosis takes into account the clinical picture and imaging tests. In this article, we present the case of a patient with restricted performance of activities of daily living and loss of quality of life due to hemophilic arthropathy in the right ankle. After total joint arthroplasty of the affected joint, there was improvement in the preoperative parameters of the patient. Level V of Evidence; Expert Opinion.Como citar esse artigo: Silva JLV, Pacheco LRL, Nakahashi ER, Picini M. Artroplastia total do tornozelo (ATT) em paciente hemofílico: relato de caso. Sci J Foot Ankle. 2018;12(1):72-6.