Spontaneous locking of the knee after anterior cruciate ligament reconstruction as a result of a broken tibial fixation device.
The Intrafix device (DePuy Mitek, Raynham, MA) is one of a number of recently developed products whose aim is to improve fixation of quadrupled hamstring grafts when used for anterior cruciate ligament reconstruction. We present a case of failure and intra-articular migration of the sleeve of an Intrafix device causing locking of the knee 10 weeks after anterior cruciate ligament reconstruction. We were unable to identify the cause of the failure or migration of the device. Rehabilitation had been progressing normally and without incident. The broken fragments were removed arthroscopically, and the reconstruction was found to be intact and healing well. Presumably, the device retained enough mechanical function to allow healing to progress, despite failure of the sleeve. This is, to our knowledge, the first reported case of such an event occurring with the new generation of hamstring graft fixation devices.
Metcalfe
Andrew J
AJ
University Hospital of Wales, Cardiff, Wales. ametcalfe@doctors.org.uk
James
Stuart H
SH
Fairclough
John A
JA
D000063:Accidents, Traffic; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D010149:Postoperative Pain; D011859:Radiography; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D013035:Spasm / Q000209:etiology