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Broken Delta interference screw after ACL reconstruction: a report of two cases
1Department of Orthopedics, St Antonius Hospital, Nieuwegein, The Netherlands. s.bollen@hccnet.nl
Summary
A broken biodegradable interference screw dislocated within the knee joint in two patients. This complication occurred after surgery for an unstable knee using a semitendinosis gracilis graft.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Sports medicine
Background:
- Biodegradable interference screws are utilized for graft fixation in anterior cruciate ligament reconstruction.
- The semitendinosis gracilis graft is a common choice for anterior cruciate ligament reconstruction.
- Unstable knee injuries often require surgical intervention for joint stabilization.
Observation:
- Two cases presented with intra-articular dislocation of the proximal portion of a fractured biodegradable interference screw.
- The screws were used for tibial fixation of a semitendinosis gracilis graft.
- The dislocations occurred in the knee joint itself.
Findings:
- Complete breakage of the biodegradable interference screw was identified as the cause of dislocation.
- The proximal fragment of the screw migrated into the joint space.
- This complication potentially compromises graft fixation and joint stability.
Implications:
- This highlights a potential failure mode for biodegradable interference screws in orthopedic surgery.
- Surgeons should be aware of the risk of screw breakage and intra-articular migration.
- Further research into the long-term durability and failure mechanisms of biodegradable fixation devices is warranted.