Guía de práctica clínica sobre diagnóstico y manejo de las rupturas agudas del ligamento cruzado anterior (LCA)

Abstract

Development of a clinical practice guideline based on the best availible clinical evidence on the diagnosis and treatment of acute anterior cruciate ligament (ACL) ruptures, to assist in the decision making and control of the variability of the clinical process. A guideline development group (GDG) was established and according to the methodology developed at the hospital´s academic center and the national department of health, accomplishing the following stages: Priorization, focus and scope definition, development of clinical questions relevant to the pathology´s state of the art and controversy issues (PECOT methodology), systematic review of the literature, synthesis of the evidence, evaluation and grading according to the “GRADE” and “SIGN” methodology. By means of consensus and the “GRADE” methodology, the recommendations were approved. A clinical practice guideline (CPG) that comprehends the following topics: haemarthrosis approach, surgical indications, preoperative physical therapy, antithrombotic prophylaxis, graft types, intrarticular anaesthesia, associated injuries, femoral tunnel position, one or two ace reconstruction. In consequence with the evidence found, twelve recommendations are formulated. The present CPG is the first essay of an approved methodology to develop CPG nationwide and a unique product of the pathology on the literature found.