Riesgos y beneficios de la plastia del ligamento cruzado anterior con aloinjerto en inestabilidad de rodilla, caracterización según factores de riesgo
Fecha
2019
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El tratamiento de la inestabilidad anterior de rodilla es un campo dinámico y en
evolución, las estrategias terapéuticas cambian a medida que obtenemos una mejor
comprensión de la cinemática de los resultados postoperatorios que permitan el
reconocimiento de las principales causas de insuficiencia quirúrgica de lesiones de
ligamento cruzado anterior, detección de riesgo de lesión y prevención primaria. El
presente trabajo tiene como objetivo analizar los riesgos y beneficios de la plastia de
ligamento cruzado anterior con aloinjerto en inestabilidad de rodilla y caracterización
según factores de riesgo en pacientes del Hospital Alcívar durante el período 2016-2017.
La metodología del estudio es de enfoque cuantitativo, diseño no experimental, de tipo
analítico, retrospectivo y longitudinal. Se analizaron 118 pacientes que cumplieron con
los criterios de inclusión con inestabilidad anterior de rodilla y que tuvieron tratamiento
quirúrgico en el departamento de Traumatología y Ortopedia del Hospital Alcívar,
durante el periodo del 1 de enero del 2016 hasta el 31 de diciembre del 2017. La
evaluación funcional se realizó mediante la aplicación de la Escala Lysholm. Se
demostraron resultados excelentes (86,44%) y buenos (9,32%) con la escala Lysholm en
el postoperatorio. La puntuación promedio Lysholm antes de la cirugía es de 43,69 puntos
y después de la misma es de 92,70 puntos (p 0,0001). El promedio de flexión
preoperatoria es de 33,95º y postoperatorios de 129,76º. Se encontró 4% de
complicaciones postoperatorias. Existe correlación entre los resultados funcionales
(Escala Lysholm) y el tiempo de inicio de la rehabilitación física (p = 0,001). Se concluye
que la plastia de LCA con aloinjerto es una procedimiento que mejora considerablemente
la funcionabilidad de la rodilla y la calidad de vida de los pacientes que tenían
inestabilidad anterior, mejora significativamente el rango de movilidad articular y el
inicio temprano de la rehabilitación física mejora el resultado funcional posoperatorio.
Palabras clave: aloinjerto, ligamento cruzado anterior, evaluación funcional.
The treatment of anterior knee instability is a dynamic and evolving field, therapeutic strategies change as we gain a better understanding of the kinematics of postoperative results that allow the recognition of the main causes of surgical failure of cruciate ligament injuries previous, detection of injury risk and primary prevention. The objective of this study is to analyze the risks and benefits of anterior cruciate ligament plasty with allograft in knee instability and characterization according to risk factors in patients of the Alcívar Hospital during the 2016-2017 period. The methodology of the study is quantitative, non-experimental design, analytical, retrospective and longitudinal. We analyzed 118 patients who met the inclusion criteria with anterior knee instability and who had surgical treatment in the Department of Traumatology and Orthopedics of Hospital Alcívar, during the period from January 1, 2016 until December 31, 2017. Functional evaluation was performed by applying the Lysholm Scale. Excellent results (86.44%) and good results (9.32%) were demonstrated with the Lysholm scale in the postoperative period. The average Lysholm score before surgery is 43.69 points and after it is 92.70 points (p 0.0001). The average preoperative flexion is 33.95º and postoperative 129.76º. 4% of postoperative complications were found. There is a correlation between the functional results (Lysholm Scale) and the start time of physical rehabilitation (p = 0.001). It is concluded that the allograft LCA plasty is a procedure that considerably improves the functionality of the knee and the quality of life of patients who had previous instability, significantly improves the range of joint mobility and the early start of physical rehabilitation improves the postoperative functional result. Key words: allograft, anterior cruciate ligament, functional evaluation
The treatment of anterior knee instability is a dynamic and evolving field, therapeutic strategies change as we gain a better understanding of the kinematics of postoperative results that allow the recognition of the main causes of surgical failure of cruciate ligament injuries previous, detection of injury risk and primary prevention. The objective of this study is to analyze the risks and benefits of anterior cruciate ligament plasty with allograft in knee instability and characterization according to risk factors in patients of the Alcívar Hospital during the 2016-2017 period. The methodology of the study is quantitative, non-experimental design, analytical, retrospective and longitudinal. We analyzed 118 patients who met the inclusion criteria with anterior knee instability and who had surgical treatment in the Department of Traumatology and Orthopedics of Hospital Alcívar, during the period from January 1, 2016 until December 31, 2017. Functional evaluation was performed by applying the Lysholm Scale. Excellent results (86.44%) and good results (9.32%) were demonstrated with the Lysholm scale in the postoperative period. The average Lysholm score before surgery is 43.69 points and after it is 92.70 points (p 0.0001). The average preoperative flexion is 33.95º and postoperative 129.76º. 4% of postoperative complications were found. There is a correlation between the functional results (Lysholm Scale) and the start time of physical rehabilitation (p = 0.001). It is concluded that the allograft LCA plasty is a procedure that considerably improves the functionality of the knee and the quality of life of patients who had previous instability, significantly improves the range of joint mobility and the early start of physical rehabilitation improves the postoperative functional result. Key words: allograft, anterior cruciate ligament, functional evaluation
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ALOINJERTOS, LIGAMENTO CRUZADO ANTERIOR, EVALUACION FUNCIONAL, FACTORES DE RIESGO, HOSPITAL ALCIVAR, CANTON GUAYAQUIL, ECUADOR, TRAUMATISMOS DE RODILLA, INESTABILIDAD DE LA ARTICULACION, ESTUDIO RETROSPECTIVO, EPIDEMIOLOGIA ANALITICA