¿Qué ocurre con las lesiones del ligamento cruzado anterior, su tratamiento, la recuperación de la función y el desarrollo de osteoartritis a largo plazo? ¿Ha espacio para el tratamiento conservador? Revisión de conceptos actuales
DOI:
https://doi.org/10.1016/j.rccot.2017.03.007Palabras clave:
ligamento cruzado anterior, tratamiento conservador, prevenciónResumen
La historia natural y el tratamiento de las lesiones del ligamento cruzado anterior (LCA) de la rodilla generan mucha controversia porque en algunos individuos la articulación queda poco funcional después de una rotura del LCA, mientras que en otros permanece relativamente asintomática y el paciente es capaz de retornar a una actividad deportiva exigente, al menos por un tiempo. Entonces cabe preguntarse: ¿es la rotura del LCA el principio del fin de la carrera de un deportista, como se ha sugerido, o la mayoría de los pacientes con esas lesiones puede responder bien al tratamiento conservador y retomar las actividades deportivas sin restricción? Aunque no hay respuestas definitivas a esta pregunta, la información disponible en la bibliografía y la experiencia pueden ayudar a definir cuál va a ser el tratamiento y a seleccionar apropiadamente a los pacientes que responderán bien a una intervención quirúrgica. Además, la identificación de los individuos que corren el riesgo de rotura del LCA, sea por primera vez o de forma repetida, también puede ayudar a prevenir estas lesiones. En este artículo se lleva a cabo una revisión del tema y se trata de ofrecer una orientación para tomar la mejor decisión ante un paciente con rotura del LCA.
Nivel de evidencia clínica: Nivel IV.
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