Skip to main content
Log in

Recurrent locking of knee joint caused by intraarticular migration of bioabsorbable tibial interference screw after arthroscopic ACL reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Two cases are reported in which, after ACL reconstruction with autologous hamstring grafts, tibial polylactide interference screws migrated into the knee joint. Clinically, both patients presented with recurrent locking of the joint. In one case, a broken 15 mm-long tip of the screw was found intra-articularly. In the other case, the whole screw had migrated into the joint cavity. The degradation process of polylactic acid, operative technique and bone quality are discussed as possible reasons for these complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bergsma EJ, de Bruijn WC, Rozema FR, Bos RRM, Boering G (1995) Late degeneration tissue response to poly(L-lactide) bone plates and screws Biomaterials 16:25–31

    Article  PubMed  CAS  Google Scholar 

  2. Bottoni C, Deberardino T, Fester E, Mitchell D, Penrod B (2000) An intra-articular bioabsorbable interference screw mimicking an acute meniscal tear 8 months after an anterior cruciate ligament reconstruction Arthroscopy 16(4):395–398

    Article  PubMed  CAS  Google Scholar 

  3. Brand JC, Nyland J, Caborn D, Johnson D (2005) Soft-tissue interference fixation: bioabsorbable screw versus metal screw Arthroscopy 21(8):911–916

    Article  PubMed  Google Scholar 

  4. Caborn D, Nyland J, Selby J, Tetik O (2003) Biomechanical testing of hamstring graft tibial tunnel fixation with bioabsorbable interference screws Arthroscopy 19(9):991–996

    Article  PubMed  Google Scholar 

  5. Chang H, Nyland J, Nawab A, Burden R, Caborn D (2005) Biomechanical comparison of the bioabsorbable Retroscrew system, Bioscrew Xtralok with stress equalization tensioner, and 35-mm delta screws for tibialis anterior graft-tibial tunnel fixation in porcine tibiae Am J Sports Med 33(7):1057–1064

    Article  PubMed  Google Scholar 

  6. Kaeding C, Farr J, Kavanaugh T, Pedroza A (2005) A prospective randomized comparison of bioabsorbable and titanium anterior cruciate ligament interference screws. Arthroscopy 21(2):147–151

    Article  PubMed  Google Scholar 

  7. Kousa P, Jarvinen TL, Vihavainen M, Kannus P, Jarvinen M (2003) The fixation strength of six hamstring tendon graft fixation devices in anterior cruciate ligament reconstruction. Am J Sports Med 31(2):182–188

    PubMed  Google Scholar 

  8. Lembeck B, Wulker N (2005) Severe cartilage damage by broken poly-L-lactic acid (PLLA) interference screw after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 13(4):283–286

    Article  PubMed  Google Scholar 

  9. Macdonald P, Arneja S (2003) Biodegradable screw presents as a loose inra-articular body after anterior cruciate ligament reconstruction. Arthroscopy 19(6):E22–E24

    Article  PubMed  Google Scholar 

  10. Martinek V, Seil R, Lattermann C, Watkins S, Fu F (2001) The fate of the poly-L-lactic acid interference screw after anterior cruciate ligament reconstruction. Arthroscopy 17(1):73–76

    Article  PubMed  CAS  Google Scholar 

  11. Morgan C, Gehrmann R, Jayo M, Johnson C (2002) Histologic findings with a bioabsorbable anterior cruciate ligament interference screw explant after 2,5 years in vivo. Arthroscopy 18(9):E47

    Article  PubMed  Google Scholar 

  12. Pistner H, Gutwald R, Ordung R, Reuther J, Mühling J (1993) Poly(L-lactide): a long-term degradation study in vivo. Part I: biological results. Biomaterials 14:671–677

    Article  PubMed  CAS  Google Scholar 

  13. Radford M, Noaks J, Read J, Wood D (2005) The natural history of a bioabsorbable interference screw used for anterior cruciate ligament reconstruction with a 4-strand hamstring technique. Athroscopy 21(6):707–710

    Google Scholar 

  14. Rupp S, Seil R, Schneider A, Kohn D (1999) Ligament graft initial fixation strength using biodegradable interference screws. J Biomed Mater Res 48(1):70–74

    Article  PubMed  CAS  Google Scholar 

  15. Steenlage E, Brand JC, Johnson D, Caborn D (2002) Correlation of bone tunnel diameter with quadrupled hamstring graft fixation strength using a biodegradable interference screw. Arthroscopy 18(8):901–907

    Article  PubMed  Google Scholar 

  16. Weiler A, Hofmann R, Stählin A, Helling H, Südkamp N (2000) Biodegradable implants in sports medicine: the biological base. Arthroscopy 16(3):305–321

    Article  PubMed  CAS  Google Scholar 

  17. Werner A, Wild A, Ilg A, Krauspe R (2002) Secondary intra-articular dislocation of a broken bioabsorbable interference screw after anterior cruciate ligament reconstruction Knee Surg Sports Traumatol Arthrosc 10:30–32

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andreas Appelt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Appelt, A., Baier, M. Recurrent locking of knee joint caused by intraarticular migration of bioabsorbable tibial interference screw after arthroscopic ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 15, 378–380 (2007). https://doi.org/10.1007/s00167-006-0220-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-006-0220-9

Keywords

Navigation