Pretibial ganglion-like cyst formation after anterior cruciate ligament reconstruction: a consequence of the incomplete bony integration of the graft?

We report a case of subcutaneous pretibial ganglion, with direct communication to the tibial tunnel after an autologous reconstruction of the anterior cruciate ligament with hamstring tendons. The tibial graft fixation was with a 9 mm poly-L-lactide interference screw 5 years earlier. The screw had undergone complete resorption at the time the cyst occurred. No joint inflammatory reaction or graft insufficiency was detected. The patient underwent cyst excision and curettage of the tibial tunnel with full recovery. This complication seems to be the consequence of a direct communication between the joint and the pretibial subcutaneous tissue through a fibrous tibial tunnel and would have occurred, as there is no full osteointegration of the graft due to the resorption of the bioabsorbable interference screw.