Severe cartilage damage from a broken absorbable screw head after fixation of an avulsion fracture of the tibial attachment of the posterior cruciate ligament: A case report

Medicine (Baltimore). 2016 Oct;95(43):e5180. doi: 10.1097/MD.0000000000005180.

Abstract

Introduction: The use of bioabsorbable interference screws has become popular for treatment of avulsion fractures of the posterior cruciate ligament (PCL). Complications are uncommon. We report a case of severe chondral damage caused by the early breakage of an absorbable screw head after fixation of an avulsion fracture of the tibial attachment of the PCL. The patient felt a sudden locking of the knee when getting off a car at 4 months after the PCL surgery. MRI revealed intraarticular migration of the head of the interference screw. During revision surgery, the broken part was removed without incident, and severe cartilage damage was observed. The patient experienced a complete resolution of symptoms at the 6-month follow-up.

Conclusion: MRI examination is recommended in case of sudden locking of the knee for patients undergoing PCL fixation with bioabsorbable interference screws. Surgical treatment should be performed immediately when screw breakage was confirmed.

Publication types

  • Case Reports

MeSH terms

  • Absorbable Implants / adverse effects*
  • Arthroscopy
  • Bone Screws / adverse effects*
  • Cartilage, Articular / diagnostic imaging
  • Cartilage, Articular / injuries*
  • Equipment Failure
  • Follow-Up Studies
  • Fracture Fixation, Internal / adverse effects*
  • Fractures, Avulsion / diagnosis
  • Fractures, Avulsion / surgery*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Posterior Cruciate Ligament / diagnostic imaging
  • Posterior Cruciate Ligament / surgery*
  • Tibial Fractures / diagnosis
  • Tibial Fractures / surgery*