Chao-Hua Fang1,2, Ming Li1, Yun-Feng Zhang1, Hua Liu3. 1. Department of Joint Surgery, Ningbo No.6 Hospital, No.1059 Zhongshan road, Yinzhou District, Zhejiang, 315000, Ningbo, People's Republic of China. 2. School of Biomedical Engineering, Shanghai Jiao Tong University, No.1954 Huashan Road, Xuhui District, 200240, Shanghai, People's Republic of China. 3. Department of Joint Surgery, Ningbo No.6 Hospital, No.1059 Zhongshan road, Yinzhou District, Zhejiang, 315000, Ningbo, People's Republic of China. liuhua_nbly@sohu.com.
Abstract
BACKGROUND: The interference screw is the most popular device that fixes the graft for anterior cruciate ligament reconstruction, reducing the incidence of windshield effect and bungee effect. For the screw, either metallic, "bioresorbable," or polyetheretherketone (PEEK) material is available. PEEK is popular and extensively used due to its stability, biocompatibility, radiolucency, and elastic modulus. Rare relevant complications were reported, but here, we report two cases of extra-articular migrations of PEEK interference screw from the tibial tunnel after anterior cruciate reconstruction. CASE REPORT: An 18-year-old boy and a 56-year-old woman underwent anterior cruciate ligament reconstruction using a PEEK interference screw to fix the graft in the tibial tunnel. They suffered from screw extrusion from the tibial tunnel after 40 days and six months, respectively, with an incision rupture or palpable subcutaneous mass. They underwent a second operation and recovered well. CONCLUSIONS: The exact incidence of extra-articular migrations of PEEK interference screws is unknown, but it seems to be quite low; despite this and its uncertain cause, the negative effects caused by the PEEK material need to be considered.
BACKGROUND: The interference screw is the most popular device that fixes the graft for anterior cruciate ligament reconstruction, reducing the incidence of windshield effect and bungee effect. For the screw, either metallic, "bioresorbable," or polyetheretherketone (PEEK) material is available. PEEK is popular and extensively used due to its stability, biocompatibility, radiolucency, and elastic modulus. Rare relevant complications were reported, but here, we report two cases of extra-articular migrations of PEEK interference screw from the tibial tunnel after anterior cruciate reconstruction. CASE REPORT: An 18-year-old boy and a 56-year-old woman underwent anterior cruciate ligament reconstruction using a PEEK interference screw to fix the graft in the tibial tunnel. They suffered from screw extrusion from the tibial tunnel after 40 days and six months, respectively, with an incision rupture or palpable subcutaneous mass. They underwent a second operation and recovered well. CONCLUSIONS: The exact incidence of extra-articular migrations of PEEK interference screws is unknown, but it seems to be quite low; despite this and its uncertain cause, the negative effects caused by the PEEK material need to be considered.