Department of Radiology, University of Florida College of Medicine, P.O. Box 100374, Gainesville, FL 32610-0374, USA.
Skeletal Radiol. 2011 Feb;40(2):229-32. doi: 10.1007/s00256-010-1019-9. Epub 2010 Aug 25.
Bioabsorbable interference screws are commonly used to secure the graft during anterior cruciate ligament (ACL) reconstruction, in part because they result in less image degradation on subsequent magnetic resonance imaging (MRI). However, some bioabsorbable screws are associated with abnormalities on MRI examination not reported with metallic interference screws. We describe a finding on knee MRI examination after ACL reconstruction using a polylactide carbonate (PLC) bioabsorbable screw that we believe to be previously unreported with any other bioabsorbable screws. The finding raised suspicion of hemorrhage or infection, neither of which were present clinically. Analysis of tissue from the tibial tunnel suggested an explanation for the MRI finding: calcite crystals. An additional five patients with knee MRI examinations after ACL reconstruction using a PLC screw were reviewed and correlated with clinical findings with four having similar imaging abnormalities present. The PLC (Calaxo screw, Smith and Nephew, Andover, MA) screw used in these patients has been recalled in the United States and Europe by the manufacturer after a greater than expected incidence of adverse reactions, and legal action may be pending.
可吸收干扰螺钉通常用于在前交叉韧带 (ACL) 重建中固定移植物，部分原因是它们在随后的磁共振成像 (MRI) 中导致的图像降级较少。然而，一些可吸收螺钉与 MRI 检查中的异常有关，这些异常在使用金属干扰螺钉时并未报告。我们描述了使用聚丙交酯碳酸酯 (PLC) 可吸收螺钉进行 ACL 重建后的膝关节 MRI 检查结果，我们认为这是以前任何其他可吸收螺钉都没有报告过的。该结果提示存在出血或感染的可能性，但临床上均未出现。对来自胫骨隧道的组织进行分析，为 MRI 结果提供了一种解释：方解石晶体。另外五名接受 ACL 重建后使用 PLC 螺钉的膝关节 MRI 检查的患者进行了回顾分析，并与临床发现相关，其中四名患者存在类似的影像学异常。这些患者使用的 PLC（Calaxo 螺钉，Smith and Nephew，安多弗，MA）螺钉已被制造商召回，原因是不良反应的发生率高于预期，可能会有法律诉讼。
