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Proximal Tibia Fracture Through Suture Augmentation Sites Following ACL/MCL Repairs: A Case Report.

Scott M Feeley1,2, Arash Kamali2, Donald F Colantonio3

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|June 24, 2024
PubMed
Summary
This summary is machine-generated.

Suture augmentation (SA) for knee ligament repair can lead to rare tibial fractures propagating through anchor sites. This case highlights a new complication of SA, emphasizing surgeon awareness for active individuals undergoing multiligament knee surgery.

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Area of Science:

  • Orthopedic surgery
  • Sports medicine
  • Biomaterials engineering

Background:

  • Suture augmentation (SA) is increasingly used in ligamentous knee reconstructions.
  • Complications associated with SA are considered rare but may be underreported.
  • The long-term safety and complication profile of SA, especially in multiligament reconstructions, requires further investigation.

Purpose of the Study:

  • To report a novel complication of suture augmentation (SA) in anterior cruciate ligament (ACL) and medial collateral ligament (MCL) repair.
  • To identify potential risk factors associated with this complication.
  • To inform surgeons about potential risks when using SA in active patients undergoing complex knee surgery.

Main Methods:

  • Case report of a 35-year-old male patient with a proximal tibia fracture.
  • The fracture occurred one year after ACL and MCL repair with SA.
  • Radiographic and clinical assessment of the fracture propagation through SA anchor sites.

Main Results:

  • The patient sustained a proximal tibia fracture due to a low-energy mechanism.
  • The fracture line extended through both tibial anchor sites used for SA.
  • Successful treatment with intramedullary tibial nailing allowed the patient to return to his previous functional level.

Conclusions:

  • This case documents a previously unreported complication of SA: tibial fracture through anchor sites.
  • The increasing use of SA necessitates a comprehensive understanding of its potential complications.
  • Surgeons should consider the risk of anchor site failure and subsequent fracture in active individuals undergoing SA for multiligament knee reconstructions.