Arthroscopy: The Journal of Arthroscopic & Related Surgery
Case ReportsDevelopment of a synovial cyst following anterior cruciate ligament reconstruction☆
Section snippets
Case report
A 16-year-old female soccer player sustained a grade III left ACL tear while planting her left foot to kick a soccer ball. After presentation to the orthopaedic clinic, her examination revealed a positive Lachman test and a positive pivot shift phenomenon. She underwent an uncomplicated reconstruction of her left ACL using the single-incision bone–patellar tendon–bone autograft technique. Fixation of the graft was achieved with a metal interference screw (Acufex, Mansfield, MA); the tibial bone
Discussion
Synovial fistulas of the knee are rare complications of arthroscopic procedures. A synovial fistula may form outside the joint space under a variety of circumstances. Fistulas reportedly have formed at portal sites used for the insertion of arthroscopic instruments.3, 4, 5 Synovial cysts originating from the tibial bone canals have also been reported.6, 7 These were associated with osteolysis of the tibial bone plugs from a bone–patellar tendon–bone allograft. However, to our knowledge, there
Conclusions
Synovial fistulas and cysts may form during arthroscopic procedures in which nonabsorbable sutures traversing through a joint, bone tunnel, and cortex are used. This complication is exceedingly rare but may still occur. If pull-through traction sutures are to be left behind, we advocate the use of an absorbable suture as a traction suture on bone plugs. If a fistula and cyst do form, simple excision with curettage should be curative.
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Cited by (12)
Pretibial Cyst Formation After Anterior Cruciate Ligament Reconstruction With a Hamstring Tendon Autograft
2006, Arthroscopy - Journal of Arthroscopic and Related SurgeryRecurrent Pretibial Ganglion Cyst Formation over 5 Years after Anterior Cruciate Ligament Reconstruction
2004, Arthroscopy - Journal of Arthroscopic and Related SurgeryAn evidence-based etiology study of synovial cyst of knee cruciate ligament: a real or pseudo-cyst
2019, International OrthopaedicsMechanical strength of fixation of anterior crucial ligament implants
2018, Russian Journal of Biomechanics
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Address correspondence and reprint requests to Gregory C. Fanelli, M.D., Chief, Sports Medicine and Arthroscopy Service, Geisinger Medical Center, Geisinger Health Systems, Danville, PA 17822-2130, U.S.A. E-mail: [email protected]