Broken bioabsorbable tibial interference screw post-arthroscopic anterior cruciate ligament reconstruction: A case report.

Abstract

Background: Bioabsorbable interference screws are a widely used option for graft fixation in anterior cruciate ligament (ACL) reconstruction. Their ability to degrade over time and avoid secondary hardware removal makes them advantageous. However, complications such as breakage and intra-articular migration of screws can cause significant clinical issues, including joint pain, swelling, and cartilage damage. Early diagnosis and management are critical in such cases.

Case summary: A 26-year-old male presented with knee pain and swelling one year after ACL reconstruction using a hamstring graft and bioabsorbable tibial interference screw. The patient had been engaged in rigorous physical activity as part of military training. Clinical examination revealed mild effusion without instability, and imaging showed screw breakage with intra-articular migration. Therapeutic arthroscopy confirmed intact graft tension, and broken screw fragments were removed successfully. The patient resumed normal activity two weeks after surgery.

Conclusion: This case highlights the potential complications associated with bioabsorbable screws, emphasizing the need for meticulous surgical technique, postoperative monitoring, and timely intervention. A comprehensive review of the literature illustrates the mechanisms, risk factors, and preventive strategies associated with screw-related complications.