Roy Mainak, Bhikshavarthi Math Suhas Aradhya, Das Deepanjan, Dwidmuthe Samir
Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Bhubaneshwar 751019, Odisha, India.
Department of Orthopaedics, All India Institute of Medical Sciences Nagpur, Nagpur 441108, Maharashtra, India.
World J Clin Cases. 2025 Aug 16;13(23):105003. doi: 10.12998/wjcc.v13.i23.105003.
Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament (ACL) reconstruction. Their ability to degrade over time and avoid secondary hardware removal makes them advantageous. However, complications such as breakage and intra-articular migration of screws can cause significant clinical issues, including joint pain, swelling, and cartilage damage. Early diagnosis and management are critical in such cases.
A 26-year-old male presented with knee pain and swelling one year after ACL reconstruction using a hamstring graft and bioabsorbable tibial interference screw. The patient had been engaged in rigorous physical activity as part of military training. Clinical examination revealed mild effusion without instability, and imaging showed screw breakage with intra-articular migration. Therapeutic arthroscopy confirmed intact graft tension, and broken screw fragments were removed successfully. The patient resumed normal activity two weeks after surgery.
This case highlights the potential complications associated with bioabsorbable screws, emphasizing the need for meticulous surgical technique, postoperative monitoring, and timely intervention. A comprehensive review of the literature illustrates the mechanisms, risk factors, and preventive strategies associated with screw-related complications.
生物可吸收挤压螺钉是前交叉韧带(ACL)重建术中广泛用于移植物固定的一种选择。它们随时间降解并避免二次取出内固定物的能力使其具有优势。然而,螺钉断裂和关节内移位等并发症可导致严重的临床问题,包括关节疼痛、肿胀和软骨损伤。在此类病例中,早期诊断和处理至关重要。
一名26岁男性在使用腘绳肌移植物和生物可吸收胫骨挤压螺钉进行ACL重建术后一年出现膝关节疼痛和肿胀。该患者作为军事训练的一部分一直进行高强度体育活动。临床检查发现有轻度积液但无不稳定,影像学检查显示螺钉断裂并关节内移位。治疗性关节镜检查证实移植物张力完好,成功取出断裂的螺钉碎片。患者术后两周恢复正常活动。
本病例突出了生物可吸收螺钉相关的潜在并发症,强调了需要精细的手术技术、术后监测和及时干预。对文献的全面回顾阐明了与螺钉相关并发症的机制、危险因素和预防策略。