Delayed Knee Locking after Complicated Anterior Cruciate Ligament Reconstruction Despite Good Stability Using A Bio-Transfix

We describe a case of delayed cyst formation that presented as intermittent knee locking after complicated anterior cruciate ligament (ACL) reconstruction using a Bio-TransFix implant in a 21-year-old male patient. During femoral fixation, we could not pull out the guide wire that was temporarily used for the femoral fixation. However, stability was good, and the guide wire was not removed. This was shown to be a wrong type of fixation in a later study. During follow-up, the patient was satisfied and stability was relatively good until 18 months post-operatively. From the 2nd post-operative year, he experienced intermittent knee swelling and locking and pain around the lateral femoral condyle. Follow-up magnetic resonance imaging showed a large cyst around the broken wire tip, but the reconstructed ACL was fine.

The Clinical Results of ACL Reconstruction with the Bio-Transfix(R) Technique

PURPOSE: We wanted to evaluate the clinical results of ACL reconstructions with using four strands of an auto-hamstring tendon graft and a bioresorbable-Transfix device (Arthrex, Naples, FL) for femoral fixation. MATERIALS AND METHODS: From May 2005 to May 2007, a total of 108 cases that underwent arthroscopic ACL reconstruction with using hamstring tendons and a bioresorbable-Transfix device were followed-up for more than 1 year (Range: 12~32 months) postoperatively. The clinical results were evaluated by the preoperative and postoperative Lysholm knee scores, the International Knee Documentation Committee (IKDC) scoring system and a KT-1000 arthrometer. The radiological results were evaluated by the measurement method described by L'Insalata. RESULTS: Preoperatively, the mean Lysholm knee score was 70.8+/-6.8 (Range: 52.0~81.0) which improved to 94.2+/-4.8 (Range: 76.0~98.0) at the last follow up (p<0.05). According to the IKDC scoring system, 104 cases (96%) were categorized as normal or nearly normal and no case was categorized as severely abnormal at the last follow up (p<0.05). KT-1000 arthrometer instability was statistically improved from 8.8 mm (Range: 3~17 mm) to 2.1 mm (Range: 1~7 mm) (p<0.05). The femoral and tibial tunnels were statistically widened 22.7% and 12.7% on the AP view, respectively, and 17.4% and 8.4% on the lateral view, respectively, at the last follow up (p<0.05). CONCLUSION: ACL reconstruction using auto-hamstring tendons with a bioresorbable-Transfix device showed satisfactory results on the physical examination and functional evaluation.