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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2018; 59(03): 095-099
DOI: 10.1055/s-0039-1677756
Review Article | Artículo de Revisión
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Rigidez en cirugía de reconstrucción del ligamento cruzado anterior

Knee Stiffness in Anterior Cruciate Ligament Reconstruction
David Figueroa
1   Departmento de Traumatología y Ortopedia, Clínica Alemana de Santiago SA, Vitacura, Región Metropolitana, Chile
,
Jaime Espinoza
2   Clínica Alemana Santiago, Universidad del Desarrollo, Vitacura, Región Metropolitana, Chile
,
Claudio Yañez
2   Clínica Alemana Santiago, Universidad del Desarrollo, Vitacura, Región Metropolitana, Chile
,
Nazira Bernal
2   Clínica Alemana Santiago, Universidad del Desarrollo, Vitacura, Región Metropolitana, Chile
› Author Affiliations
Further Information

Publication History

28 October 2018

04 December 2018

Publication Date:
21 February 2019 (online)

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Resumen

La rigidez de rodilla en cirugía de Reconstrucción del Ligamento Cruzado Anterior (R-LCA) es una complicación devastadora, alcanzando una incidencia variable entre el 4% y el 38%. La definición de artrofibrosis es aún poco clara, lo que ha llevado a distintos esquemas terapéuticos. Conocer la etiopatogenia es clave para entender los procesos y las posibles alternativas de tratamiento. Distintas clasificaciones han sido descritas, siendo la de Shelbourne la más usada, debido a su valor pronóstico asociado. El objetivo del tratamiento en una rodilla estable es mejorar la movilidad articular, la satisfacción del paciente, y disminuir el riesgo de artrosis a largo plazo. El tratamiento se puede dividir en quirúrgico y conservador. Ese último, se enfoca principalmente en buscar la causa y lograr una prevención e intervención temprana, siendo el manejo que con mayor frecuencia se realiza. El tratamiento quirúrgico es una opción cuando el tratamiento conservador falla. Se realizó una revisión de la literatura y de 150 pacientes sometidos a R-LCA, de los cuales 4 presentaron artrofibrosis a un seguimiento de 2 años. Además, presentamos nuestro algoritmo de manejo terapéutico.

Abstract

Knee stiffness in Anterior Cruciate Ligament Reconstruction (ACL-R) is a devastating complication, with a variable incidence of 4% to 38%. The definition of arthrofibrosis is still unclear, which has led to different therapeutic schemes. Knowing the etiopathogenesis is key to understanding the processes and possible treatment alternatives. Different classifications have been described, with Shelbourne being the most used, due to its associated prognostic value. The aim of treatment in a stable knee is to improve joint mobility, patient satisfaction, and decrease the risk of long-term osteoarthritis. The treatment can be divided into operative and non-operative. The latter focuses mainly on finding the cause and achieving prevention and early intervention, being the management that is most frequently performed. Surgical treatment is an option when conservative treatment fails. A review of the literature and of 150 patients undergoing R-LCA was performed, of which 4 presented arthrofibrosis at a 2-year follow-up. In addition, we present our therapeutic management algorithm.

Palabras-clave

artrofibrosis - rigidez de rodilla - artrofibrolisis - cirugia ligamentaria

Keywords

arthrofibrosis - knee stiffness - arthribrolysis - ligament surgery
 

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