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. 2016 May-Jun;30(3):150-153.

[Pretibial pseudocyst after anterior cruciate ligament reconstruction with a biocomposite screw]

[Article in Spanish]
Affiliations
  • PMID: 27984690

[Pretibial pseudocyst after anterior cruciate ligament reconstruction with a biocomposite screw]

[Article in Spanish]
B Alonso et al. Acta Ortop Mex. 2016 May-Jun.

Abstract

We report the case of a patient who presented a pretibial extra-articular cyst two years after an arthroscopically assisted ACL reconstruction using an autologous bone-patellar tendon-bone graft. The tibial fixation was achieved with a bioabsorbable screw made of poly-L, D-lactic and -tricalcium phosphate (-TCP). A subcutaneous pseudocystic lesion was excised. It consisted of a capsular fibrous tissue with minimal milky fluid (1 ml) centrally. It penetrated into the tibial tunnel but did not communicate with the knee joint space. The histopathological analysis demonstrated fibrous tissue with multinucleated giant cells and refractile particles which suggested a foreign body reaction. After the surgery, the patient recovered perfectly well and he returned to his pre-injury level of physical activity in two months. To the best of our knowledge, this is the first report of this complication in a patient with a biocomposite screw made of poly-L, D-lactic and -tricalcium phosphate (-TCP).

Presentamos el caso de un paciente con un nódulo subcutáneo pretibial de unos 20 × 15 mm dos años después de la reconstrucción del ligamento cruzado anterior con un injerto autólogo hueso-tendón-hueso de tendón rotuliano fijado en la tibia con un tornillo de interferencia reabsorbible de ácido poli-D, L-láctico y fosfato -tricálcico. Se resecó una lesión seudoquística subcutánea con contenido líquido blanquecino y abundante fibrosis circundante, que penetraba en el túnel tibial sin comunicar con la articulación. El análisis anatomopatológico describió tejido fibroso con células multinucleadas y partículas refringentes, que sugería una reacción a cuerpo extraño. Después de la intervención, la sintomatología remitió y el individuo pudo recuperar su actividad deportiva previa en menos de dos meses. No se ha encontrado en la literatura médica publicada hasta la fecha ningún trabajo que describa esta complicación en un sujeto con un tornillo de interferencia tibial de ácido poli-D, L-láctico y fosfato -tricálcico.

Keywords: Pseudocyst; anterior cruciate ligament; screw; β-tricalcium phosphate.

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