Sanchez-Munoz Enrique, Maestro Fernández Antonio, Pipa Muñiz Iván, Rodríguez García Nicolas
Knee Unit, Department of Orthopaedic Surgery and Traumatology, University Hospital of Toledo, Avenida Barber 30, ZIP 45004 Toledo, Spain.
Knee Pathology and Sports Medicine Unit, HM IMI Clinic, Av. Irlanda, 21, 45005 Toledo, Spain.
Case Rep Orthop. 2020 Mar 23;2020:3586981. doi: 10.1155/2020/3586981. eCollection 2020.
Synovial fistula and cyst formation after anterior cruciate ligament (ACL) reconstruction is very unusual and almost always affects the tibia. Only 3 cases originating in the femur have been reported. We present a rare case of late-onset femoral cyst formation related to ACL reconstruction. Ten years after successful ACL reconstruction surgery, effusion and pain at the lateral aspect of the lateral femoral condyle appeared. Symptoms persisted despite initial percutaneous drainage and conservative treatment. Surgery was carried out, with drainage and graft-fixation pin device removal, with recurrent cyst formation after the intervention. Total recovery of the patient was achieved after carrying out revision surgery consisting in bone tunnel filling using autologous bone graft and occlusion of cortical bone defect with local fascial flap. The development of this unusual complication was related to lack of absorption of the fixation device, bone burn due to drilling, and persistent synovial fluid in the femoral bone tunnel, combined with the absence of bone ingrowth.
前交叉韧带（ACL）重建术后出现滑膜瘘和囊肿形成非常罕见，且几乎总是累及胫骨。仅报告过3例起源于股骨的病例。我们呈现了1例与ACL重建相关的迟发性股骨囊肿形成的罕见病例。在成功进行ACL重建手术10年后，股骨外侧髁外侧出现积液和疼痛。尽管最初进行了经皮引流和保守治疗，症状仍持续存在。进行了手术，包括引流和取出移植物固定针装置，但术后囊肿复发。在采用自体骨移植填充骨隧道并使用局部筋膜瓣封闭皮质骨缺损进行翻修手术后，患者完全康复。这种不寻常并发症的发生与固定装置吸收不良、钻孔导致的骨灼伤、股骨骨隧道中持续存在的滑液以及骨长入缺失有关。
