J Knee Surg 2013; 26(S 01): S050-S052
DOI: 10.1055/s-0031-1299649
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Myxoid Tumor Associated to Migration of a Suspensory Fixation Device of a Reconstructed Anterior Cruciate Ligament: A Case Report

Pablo Eduardo Gelber
1   Department of Orthopaedic Surgery, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
2   ICATME-Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Juan Ignacio Erquicia
2   ICATME-Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Xavier Pelfort
2   ICATME-Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Marc Tey
2   ICATME-Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain
,
Juan Carlos Monllau
1   Department of Orthopaedic Surgery, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
2   ICATME-Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain
› Author Affiliations
Further Information

Publication History

25 January 2011

05 October 2011

Publication Date:
03 May 2012 (online)

Abstract

A 16-year-old male who had undergone 6 months before an anterior cruciate ligament (ACL) reconstruction with an autologous hamstring graft fixed with a suspensory fixation device (XoButton device; ConMed Linvatec, Largo, FL), complained of a slightly painful mass in the distal posterolateral aspect of the thigh. The knee was otherwise stable. A 79 × 60 × 17 mm multilobulated tumor surrounding the implant device was observed in magnetic resonance images. The revision arthroscopy showed an intact ACL graft. The tumor was excised through a longitudinal posterolateral approach. It had a myxoid appearance. The undamaged implant was also removed. Two months after surgery, the patient was already asymptomatic. Although most fixation device problems occur in the perioperative period due to an inadequate technique which may lead to graft instability, this case reminds clinicians of the possibility of later developing clinically relevant complications with suspensory fixation devices.

 
  • References

  • 1 Conner CS, Perez BA, Morris RP, Buckner JW, Buford Jr WL, Ivey FM. Three femoral fixation devices for anterior cruciate ligament reconstruction: comparison of fixation on the lateral cortex versus the anterior cortex. Arthroscopy 2010; 26 (6) 796-807
  • 2 Kamelger FS, Onder U, Schmoelz W, Tecklenburg K, Arora R, Fink C. Suspensory fixation of grafts in anterior cruciate ligament reconstruction: a biomechanical comparison of 3 implants. Arthroscopy 2009; 25 (7) 767-776
  • 3 Karaoglu S, Halici M, Baktir A. An unidentified pitfall of Endobutton use: case report. Knee Surg Sports Traumatol Arthrosc 2002; 10 (4) 247-249
  • 4 Miller MD. EndoButton drill bit failure. Arthroscopy 2002; 18 (3) 322-324
  • 5 Muneta T, Yagishita K, Kurihara Y, Sekiya I. Intra-articular detachment of the Endobutton more than 18 months after anterior cruciate ligament reconstruction. Arthroscopy 1999; 15 (7) 775-778
  • 6 Simonian PT, Behr CT, Stechschulte Jr DJ, Wickiewicz TL, Warren RF. Potential pitfall of the EndoButton. Arthroscopy 1998; 14 (1) 66-69
  • 7 Ahn JH, Lee YS, Chang MJ. Post-tibial cyst formation over 2 years after posterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2008; 16 (11) 996-998
  • 8 Yanmiş I, Tunay S, Oğuz E, Yildiz C, Ozkan H, Kirdemir V. Dropping of an EndoButton into the knee joint 2 years after anterior cruciate ligament repair using proximal fixation methods. Arthroscopy 2004; 20 (6) 641-643
  • 9 Anderson JM, Rodriguez A, Chang DT. Foreign body reaction to biomaterials. Semin Immunol 2008; 20 (2) 86-100