Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- 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
Otros factores de diagnóstico
- sensibilidade no côndilo femoral lateral, platô tibial lateral
- teste de gaveta anterior positivo
Factores de riesgo
- 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- radiografias
Pruebas diagnósticas que deben considerarse
- RNM
- artroscopia
Algoritmo de tratamiento
pacientes sedentários
demandas de intensidade moderada
demandas dinâmicas intensas
Colaboradores
Autores
Philip H. Cohen, MD
Clinical Assistant Professor of Medicine
Robert Wood Johnson Medical School
University of Medicine and Dentistry of New Jersey
Piscataway
NJ
Divulgaciones
PHC has been reimbursed by MCE Conferences for providing lectures and workshops in sports medicine.
Revisores por pares
James C. Puffer, MD
Professor
University of Kentucky School of Medicine
President and Chief Executive Officer
American Board of Family Medicine
Lexington
KY
Divulgaciones
JCP declares that he has no competing interests.
Jung-Ro Yoon, MD
Director
Department of Orthopedic Surgery
Seoul Veterans Hospital
Seoul
South Korea
Divulgaciones
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.
Referencias
Artículos principales
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.Texto completo Resumen
American Academy of Orthopaedic Surgeons. Management of anterior cruciate ligament injuries: evidence-based clinical practice guideline. Aug 2022 [internet publication].Texto completo
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.Texto completo Resumen
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.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Entorse do ligamento colateral medial (LCM)
- Entorse do ligamento colateral posterior
- Entorse do ligamento colateral lateral (LCL)
Más DiferencialesGuías de práctica clínica
- AAOS management of anterior cruciate ligament injuries
- ACR appropriateness criteria - acute trauma to the knee
Más Guías de práctica clínicaFolletos para el paciente
Lesão do ligamento cruzado anterior
Más Folletos para el paciente
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