Enfoque actual del tratamiento quirúrgico en la rotura de ligamento cruzado anterior

Abstract

Introduction: Anterior cruciate ligament (ACL) injury is the most prevalent ligamentous injury of the knee, causing 100,000 to 200,000 injuries in athletes each year worldwide. Objective: The objective of this work is to review the most up-to-date literature on the updated surgical treatment of anterior cruciate ligament rupture in the last 4 years, using the PubMed database, to create a useful document for medical students and residents. Surgical treatment is usually indicated in those patients who seek to continue with an active lifestyle, or return to sports activities because in patients who undergo conservative treatment and in the absence of surgical treatment, the knee remains unstable. Surgical treatment currently consists of performing intra-articular plasties using grafts and fixation systems, imitating the original anatomical points. Conclusions: The monotunnel intervention through independent drilling of the femoral tunnel was related to better results than the Transtibial approach, although the difference was not clinically significant. However, among the double-bundle anterior cruciate ligament reconstruction techniques, the technique using perforation of the anteromedial portal presented better results than the monotunnel technique, previously mentioned. Regarding femoral fixation techniques for cruciate ligament reconstruction, transverse fixation presents better clinical results than those operated on with extracortical fixation, while the interferential screw fixation technique is superior to the previous two.