Resumo
Definição
History and exam
Key diagnostic factors
- presença de fatores de risco
- estalo audível
- rápido edema do joelho
- incapacidade de retornar à atividade esportiva em andamento
- sensação de instabilidade ou curvatura do joelho
- dor
- teste de Lachman positivo
- manobra do ressalto (pivot shift) positiva
Other diagnostic factors
- sensibilidade no côndilo femoral lateral, platô tibial lateral
- teste de gaveta anterior positivo
Risk factors
- trauma agudo
- sexo feminino (após a puberdade)
- técnica incorreta de aterrissagem
- história de lesão prévia do LCA
- atleta agressivo com maior nível de habilidades
- uso de travas ou chuteiras
- superfície irregular ou desigual para prática esportiva
- estado do solo/condições meteorológicas
- fadiga
- adolescentes, jovens e atletas de meia idade
Diagnostic investigations
1st investigations to order
- radiografias
Investigations to consider
- RNM
- artroscopia
Treatment algorithm
pacientes sedentários
demandas de intensidade moderada
demandas dinâmicas intensas
Contributors
Authors
Philip H. Cohen, MD
Clinical Assistant Professor of Medicine
Robert Wood Johnson Medical School
University of Medicine and Dentistry of New Jersey
Piscataway
NJ
Disclosures
PHC has been reimbursed by MCE Conferences for providing lectures and workshops in sports medicine.
Peer reviewers
James C. Puffer, MD
Professor
University of Kentucky School of Medicine
President and Chief Executive Officer
American Board of Family Medicine
Lexington
KY
Disclosures
JCP declares that he has no competing interests.
Jung-Ro Yoon, MD
Director
Department of Orthopedic Surgery
Seoul Veterans Hospital
Seoul
South Korea
Disclosures
JRY declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Arundale AJH, Bizzini M, Giordano A, et al. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention. J Orthop Sports Phys Ther. 2018 Sep;48(9):A1-A42.Full text Abstract
American Academy of Orthopaedic Surgeons. Management of anterior cruciate ligament injuries: evidence-based clinical practice guideline. Aug 2022 [internet publication].Full text
Padua DA, DiStefano LJ, Hewett TE, et al. National Athletic Trainers' Association Position Statement: Prevention of Anterior Cruciate Ligament Injury. J Athl Train. 2018 Jan;53(1):5-19.Full text Abstract
van Melick N, van Cingel RE, Brooijmans F, et al. Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. Br J Sports Med. 2016 Dec;50(24):1506-15.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Entorse do ligamento colateral medial (LCM)
- Entorse do ligamento colateral posterior
- Entorse do ligamento colateral lateral (LCL)
More DifferentialsGuidelines
- AAOS management of anterior cruciate ligament injuries
- ACR appropriateness criteria - acute trauma to the knee
More GuidelinesPatient information
Lesão do ligamento cruzado anterior
More Patient information
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