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Early postoperative transtibial articular fistula formation after anterior cruciate ligament reconstruction: a review of three cases

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

This is a retrospective case report of three cases with an early postoperative transtibial fistula after anterior cruciate ligament reconstruction (ACL).

Materials and methods

The patients had undergone ACL reconstruction and complained of fluid drainage through the not-healed wound or swelling localized on the anteromedial aspect of the ipsilateral proximal tibia during the early postoperative. Magnetic resonance imaging showed a multilocular fluid-filled cyst arising from the distal hole of the tibial bone tunnel. Open resection of the fistula and the cyst was performed in all cases and communication between the tibial tunnel and the joint space was confirmed. During revision surgery the distal hole of the tibial tunnel was covered with a fascio-periosteal flap.

Results

All wounds healed without complications. There was no recurrence of drainage or cyst formation. At 2 years follow-up the knee function was normal and was not affected by the complication in any of the patients. Early postoperative transtibial fistulae after ACL reconstruction are rare complications that clinically present either as anterior tibial cysts or persistent wound drainage. Surgical treatment is required, and some delay in the rehabilitation routine is required, but the final outcome is not affected.

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Conflict of interest

There are no conflicts of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital Universitario Ramón y Cajal, Cta Colmenar Km 9.100, 28034, Madrid, Spain

    J. Díaz Heredia, M. A. Ruiz Iban, R. Ruiz Diaz & I. Cebreiro Martinez del Val

  2. Department of Orthopaedic Surgery, Hospital Universitario Donostia, San Sebastián, Spain

    R. Cuéllar Gutiérrez

  3. Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain

    L. Turrion Merino

Authors
  1. J. Díaz Heredia
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  2. M. A. Ruiz Iban
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  3. R. Cuéllar Gutiérrez
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  4. R. Ruiz Diaz
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  5. I. Cebreiro Martinez del Val
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  6. L. Turrion Merino
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Correspondence to J. Díaz Heredia.

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Díaz Heredia, J., Ruiz Iban, M.A., Cuéllar Gutiérrez, R. et al. Early postoperative transtibial articular fistula formation after anterior cruciate ligament reconstruction: a review of three cases. Arch Orthop Trauma Surg 134, 829–834 (2014). https://doi.org/10.1007/s00402-014-1988-6

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  • DOI: https://doi.org/10.1007/s00402-014-1988-6

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