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Case Report: Fibroxanthoma: A Complication of a Biodegradable Screw

  • Case Report
  • Knee
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Biodegradable interference screws in anterior cruciate ligament (ACL) reconstruction have gained popularity because of their similar or superior fixation strength in comparison to metallic interference screws and because they do not cause imaging artifacts and do not need to be removed.

Case Description

We report the case of a 23-year-old man who presented with slowly progressive firm swelling of 2 months’ duration at the site of the tibial tunnel 3 years after ACL reconstruction using a biodegradable interference screw. After curettage and débridement, the material was sent for histopathologic examination, which was reported as a fibroxanthoma.

Literature Review

Reported complications are osteolysis around the screw, allergic reaction, sterile abscess formation, ganglion cyst formation, and intraarticular migration. A fibroxanthoma consists of fibroblasts and mononuclear or multinucleated cells with large lipid-filled histiocytes (foam cells). The cells are negative for S-100 and keratin and positive for anti-human macrophage marker HAM-56.

Purposes and Clinical Relevance

Use of biodegradable screws is associated with high healing rates and low complication rates; however, awareness of their potential complications may help in early recognition and prevention of associated morbidity.

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Fig. 1A–B
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Authors and Affiliations

  1. The University Department of Orthopaedic Surgery, College of Medicine, King Faisal University, Dammam, Saudi Arabia

    Mir Sadat-Ali MD, PhD, FRCS, D Orth, Quamar Azzam MBBS, MS, Mohammed Bluwi MBBS, SSC (Ortho) & Abdallah S. Al-Umran MBBS, SSC (Ortho)

  2. King Fahd University Hospital, PO Box 40071, AlKhobar, 31952, Saudi Arabia

    Mir Sadat-Ali MD, PhD, FRCS, D Orth, Quamar Azzam MBBS, MS, Mohammed Bluwi MBBS, SSC (Ortho) & Abdallah S. Al-Umran MBBS, SSC (Ortho)

Authors
  1. Mir Sadat-Ali MD, PhD, FRCS, D Orth
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  2. Quamar Azzam MBBS, MS
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  3. Mohammed Bluwi MBBS, SSC (Ortho)
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  4. Abdallah S. Al-Umran MBBS, SSC (Ortho)
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Corresponding author

Correspondence to Mir Sadat-Ali MD, PhD, FRCS, D Orth.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This work was performed at King Fahd University Hospital.

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Sadat-Ali, M., Azzam, Q., Bluwi, M. et al. Case Report: Fibroxanthoma: A Complication of a Biodegradable Screw. Clin Orthop Relat Res 468, 2284–2287 (2010). https://doi.org/10.1007/s11999-009-1170-6

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  • DOI: https://doi.org/10.1007/s11999-009-1170-6

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