title: Foreign body reaction after PLC reconstruction caused by a broken PLLA screw.
abstract: Foreign body reactions may occur in patients who receive bioabsorbable implants during orthopedic surgery for fractures and ligament repair. The authors describe a 34-year-old man who presented with a palpable tender mass on the lateral aspect of the left knee of 1 month's duration. He underwent posterior cruciate ligament and posterolateral corner reconstruction 3 years earlier. Physical examination showed a 1×1-cm soft, nontender mass without localized warmth on the lateral epicondyle of the distal femur. Magnetic resonance imaging showed a broken screw fragment surrounded by a cyst-like mass. Under general anesthesia, the surgeon excised the screw fragment and the fibrotic mass, enclosing it in the subcutaneous tissue at the lateral epicondyle, the site at which a poly-L-lactic acid bioabsorbable screw had been inserted to fix the graft for posterolateral corner reconstruction. Histologic evaluation showed a foreign body reaction to the degraded screw particles. To the authors' knowledge, this report is the first description of a patient presenting with a delayed foreign body reaction to a broken poly-L-lactic acid bioabsorbable screw at the lateral femoral epicondyle after posterolateral corner reconstruction. Because delayed foreign body reactions can occur at any site of poly-L-lactic acid bioabsorbable screw insertion, care should be taken to avoid screw protrusion during ligament reconstruction because it can lead to screw breakage and delayed foreign body reaction.
authors.forename: Tae-Kwon
authors.initials: TK
authors.lastname: Kim
authors.forename: Tae-Wan
authors.initials: TW
authors.lastname: Jeong
authors.forename: Dae-Hee
authors.initials: DH
authors.lastname: Lee
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D000328:Adult; D001863:Bone Screws / Q000009:adverse effects*; D005549:Foreign-Body Reaction / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D019344:Lactic Acid; D008279:Magnetic Resonance Imaging; D008297:Male; D011091:Polyesters; D011108:Polymers; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D011475:Prosthesis Failure; D012421:Rupture / Q000601:surgery
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)