Rehabilitación kinésica de un jugador de rugby amateur con lesión multiligamentaria de rodilla:

Reporte de un caso

  • Andrés Brusco Centro de rehabilitación deportiva BEFIT, Chacabuco, Provincia de Buenos Aires, Argentina
  • Andrés Thomas BEFIT, Centro de rehabilitación deportiva, Chacabuco, Buenos Aires, Argentina
Palabras clave: informes de casos, traumatismos de la rodilla, lesion multiligamentaria de rodilla, lesion ligamentaria multiple, período posoperatorio, rugby


Introducción: La lesión multiligamentaria de rodilla (LML) ocurre por traumas de alta y baja energía. La principal causa de LML es la luxación de rodilla y representa el 0,02% de los traumas musculoesqueléticos. Actualmente no existe un protocolo estandarizado de tratamiento para dicha afección, por lo tanto, el objetivo de este estudio fue describir la evaluación y rehabilitación de un paciente con LML y su seguimiento a los 18 meses.

Presentación del caso: Paciente de sexo masculino de 28 años, jugador de rugby que presentó una LML y debió aguardar 5 meses para ser intervenido quirúrgicamente. Previo al alta, obtuvo valores funcionales de rodilla alcanzando una puntuación de 77 en la Lower Extremity Functional Scale, 97,7% en el cuestionario International Knee Documentation Committee y 100% en la escala Lysholm. Para determinar la vuelta al campo, se evaluaron los test de retorno al juego utilizados para ligamento cruzado anterior. El principal hallazgo fue su capacidad de retornar a jugar al rugby sin dificultades, independientemente de la severidad de la lesión y del tiempo que debió aguardar para intervenirse.

Conclusión: En el presente caso se describió la evaluación y tratamiento kinésico de un paciente con LML basado en la evidencia científica disponible.


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Moatshe G, Chahla J, LaPrade, RF, Engebretsen L. Diagnosis and treatment of multiligament knee injury: state of the art. JISAKOS. 2017;0(3)1–10.

Messer MS, Southam B, Grawe BM. Bilateral Multiligamentous Knee Injuries: A Case Report and Technique Review. Case Rep Orthop. 2018;19(34):6015-3.

Goyal A, Tanwar M, Joshi D, Chaudhary D. Practice Guidelines for the Management of Multiligamentous Injuries of the Knee. Indian J Orthop. 2017;51(5):537-44.

Wu T, Disney H. Physical therapy to improve mobility following surgery for multiple ligament knee injuries: A case report. Trends Med. 2017;17 (23):19.

Wilk KE, Macrina LC, Cain EL, Dugas JR, Andrews JR. Recent advances in the rehabilitation of anterior cruciate ligament injuries. J Orthop Sports Phys Ther. 2012;42(3):153-71.

Kahl C, Cleland J. Visual analogue scale, numeric pain rating scale and the McGill Pain Questionnaire: An overview of psychometric properties.Phys Ther. 2005; 10(2):123-128.

Nicholas JJ, Taylor FH, Buckingham RB, Ottonello D. Measurement of circumference of the knee with ordinary tape measure. Ann Rheum Dis. 1976;35(3):282-4.

Jenny JY. Measurement of the knee flexion angle with a Smartphone-application is precise and accurate. J Arthroplasty. 2013;28(5):784-7

Kendall F. Muscle testing and function. 5th ed. Baltimore, Maryland: Williams and Wilkins;1993.

Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, Richmond JC, Shelborne KD. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med. 2001;29(5):600-13.

Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res.1985;(198):43-9.

Dell'Era S, Dimaro M., Gamboa A, Spath MB, Salzberg S, Hernández D. Cross‐cultural adaptation and Argentine validation of the Lower Extremity Functional Scale Questionnaire. Medicina. 2016; 76(5): 279–85.

Augustovski FA, Lewin G, García-Elorrio E, Rubinstein A. The Argentine-Spanish SF-36 Health Survey was successfully validated for local outcome research. J Clin Epidemiol. 2008;61(12):1279-1284.

Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B. The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports Phys Ther. 2009;4(2):92-9.

Reid A, Birmingham TB, Stratford PW, Alcock GK, Giffin JR. Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction. Phys Ther. 2007;87(3):337-49.

Lynch A, Chmieleswski T, Bailey L, Stuart M, Cooper J,Coady C. Current Concepts and Controversies in Rehabilitation After Surgery for Multiple Ligament Knee Injury. Curr Rev Musculoskelet Med.2017;10(3):328-345.

Fitzgerald GK, Piva SR, Irrgang JJ. A modified neuromuscular electrical stimulation protocol for quadriceps strength training following anterior cruciate ligament reconstruction. J Orthop sports Phys Ther. 2003;33(9):492–501.

Snyder-Mackler L, Delitto A, Bailey SL, Stralka SW. Strength of the quadriceps femoris muscle and functional recovery after reconstruction of the anterior cruciate ligament. A prospective, randomized clinical trial of electrical stimulation. J Bone Joint Surg Am. 1995;77(8):1166-73.

Boyle, M. New funtional training for sports.2 nd ed. London: Human Kinetics;2016.

Powels, C. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40(2):42-51.

Buckthorpe M, Della Villa F. Optimising the 'Mid-Stage' Training and Testing Process After ACL Reconstruction. Sports Med. 2020;50(4):657-678.

Rambaud AJM, Ardern CL, Thoreux P, Regnaux JP, Edouard P. Criteria for return to running after anterior cruciate ligament reconstruction: a scoping review. Br J Sports Med. 2018;52(22):1437-1444.

Physiotherapy-guided versus home-based, unsupervised rehabilitation in isolated anterior cruciate injuries following surgical reconstruction. Knee Surg Sports Traumatol Arthrosc.2011;19(7):1158-67.

Backshi NK, Khan M, Lee S, Finney FT, Stotts J, Sikka,RS, Bedi A. Return to Play After Multiligament Knee Injuries in National Football League Athletes.Sports Health.2018: 10(6):495-499.

Dephillipo NN, Berning K, Laprade RF. Multi-ligament knee reconstruction and novel meniscus radial repair technique, with return to olympic level skiing: a case report. Int j sports phys ther. 2020;15(1):139-147.

Geeslin AG, LaPrade RF. Outcomes of treatment of acute grade-III isolated and combined posterolateral knee injuries: a prospective case series and surgical technique. J Bone Joint Surg Am. 2011; 21;93(18):1672-83.

McArdle S. Psychological rehabilitation from anterior cruciate ligament-medial collateral ligament reconstructive surgery: a case study. Sports Health. 2010;2(1):73-7.

Risberg MA, Holm I, Steen H, Beynnon BD. Sensitivity to changes over time for the IKDC form, the Lysholm score, and the Cincinnati knee score. A prospective study of 120 ACL reconstructed patients with a 2-year follow-up. Knee Surg Sports Traumatol Arthrosc. 1999;7(3):152-9.

Wright RW. Knee injury outcomes measures. J Am Acad Orthop Surg. 2009;17(1):31-9.

Mueller BT, O’Brien LT. Multiligament knee injuries in athletes, is it possible to return to play? —a rehabilitation perspective. Ann Joint. 2018;3:(92)1-9.

Johnston W, Duignan C, Coughlan GF, Caulfield B. Dynamic balance performance varies by position but not by age group in elite Rugby Union players - a normative study. J Sports Sci. 2019;37(11):1308-1313.

Davies WT, Myer GD, Read PJ. Is It Time We Better Understood the Tests We are Using for Return to Sport Decision Making Following ACL Reconstruction? A Critical Review of the Hop Tests. Sports Med. 2020;50(3):485-95.

Kotsifaki A, Korakakis V, Whiteley R, Rossom SV, Jonkers I. Measuring only hop distance during single leg hop testing is insufficient to detect deficits in knee function after ACL reconstruction: a systematic review and meta-analysis. Br J Sports Med. 2019;(0):1–16.

Kline PW, Johnson DL, Ireland ML, Noehren B. Clinical Predictors of Knee Mechanics at Return to Sport after ACL Reconstruction. Med Sci Sports Exerc. 2016;48(5):790-5.

Corsini, A.; Bisciotti, G.N.; Eirale, C.; Volpi, P. Football cannot restart soon during the COVID-19 emergency. A critical perspective from the Italian experience and a call for action. Br J Sports Med. 2020; 0 (0).

Mujika I. Endurance training: Science and Practice. 1 st ed. Spain: Vitoria-Gasteiz; 2012.

Rodríguez-Fernández A, Sánchez-Sánchez J, Ramirez-Campillo R, Rodríguez-Marroyo JA, Villa Vicente JG, Nakamura FY. Effects of short-term in-season break detraining on repeated-sprint ability and intermittent endurance according to initial performance of soccer player. PLoS One. 2018;15;13(8):111-201.

Cómo citar
Brusco, A., & Thomas, A. (2021). Rehabilitación kinésica de un jugador de rugby amateur con lesión multiligamentaria de rodilla: . Argentinian Journal of Respiratory & Physical Therapy, 3(3).