Early postoperative transtibial articular fistula formation after anterior cruciate ligament reconstruction: a review of three cases

Heredia, Jorge Díaz; Ibán, Miguel Ángel Ruiz; Gutiérrez, Ricardo Cuéllar; Díaz, Raquel Ruiz; Val, Ignacio Cebreiro Martinez del; Merino, Lucía Turrión

doi:10.1007/s00402-014-1988-6

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…The publication dates of the included studies ranged from 1999 to 2019. Using the adjusted Oxford Center For Evidence‐Based Medicine criteria [74, 75] for the level of evidence we found that 1 study was Level I [11], 1 Level II [25], 1 Level III [57] and 34 studies were level IV [1, 3, 10, 12–17, 19–21, 23, 29, 33, 36, 42, 43, 46, 49, 51, 53, 54, 56, 58, 59, 62, 64–66, 69, 71, 72] case series or case reports.…”

Section: Resultsmentioning

confidence: 99%

A comprehensive scoping review of tibial cysts after anterior cruciate ligament reconstruction

et al. 2021

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Purpose The purpose of this study was to perform a scoping review of published literature reporting on surgical management of tibial cysts which developed after ACLR. Methods A scoping review was conducted following the Arksey and O’Malley framework for scoping studies and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) extension for scoping reviews (PRISMA-ScR) guidelines. A search strategy using the terms [“Tibial Cyst” AND “ACL”], [“Pretibial Cyst” AND “ACL”] was applied to the PUBMED database. Results Thirty-seven studies published between 1990 and 2019 were a part of this scoping review. Non-absorbable implants for tibial graft fixation were used in 10 studies (comprising a total 21 patients), while bio-absorbable implants were used in 27 studies (comprising a total 115 patients). Incidence of tibial cyst was reported in 3 studies (434 primary ACLRs) from whom 3.9% (n = 17) developed tibial cyst. Tibial cyst development in relation to use of bio-absorbable screws for tibial ACL graft fixation was reported in 16 studies (42.1%). Use of bio-absorbable screws with another factor was found to be related to tibial cyst development in another 1 study (2.6%). Most common symptoms were presence of mass or swelling, pain, tenderness, drainage, instability and effusion. Conclusion This scoping review demonstrated that tibial cysts is more frequently related to bioabsorbable screws, however it can also occur due to other causes. Current literature on tibial cyst after ACLR is of low-quality evidence. Future research is required to better understand aetiology, risk factors for cyst formation and the best possible mode of management. Level of evidence IV

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Section: Resultsmentioning

confidence: 99%

A comprehensive scoping review of tibial cysts after anterior cruciate ligament reconstruction

et al. 2021

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“…Synovial fistula (SF) of joint is a rare pathologic condition that is formed through a defect within the joint capsule. There have been several reports of SF around the knee, shoulder, and wrist joints, which developed in the wake of intra-articular surgeries such as arthroscopic procedures [1][2][3][4][5][6][7]. Regarding its mechanism, SF operates as a check-valve and drains the synovial fluid externally into the extracapsular space.…”

Section: Introductionmentioning

confidence: 99%

Clinical Manifestations, Diagnosis and Management of Synovial Fistula Associated Lateral Ankle Sprain or Instability: A Retrospective Study of 19 Surgically Confirmed Patients

Kim

Shim

Yang

et al. 2022

IJERPH

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We aimed to investigate the preoperative history, clinical manifestations, imaging findings, and postoperative clinical outcomes for patients with surgically confirmed synovial fistula around the ankle joint. 19 consecutive patients who were confirmed to have synovial fistula in the surgical field were enrolled in this study. Medical records of all patients in terms of preoperative details, operative findings, and postoperative outcomes at 1 year after the surgery were retrieved. As a diagnostic modality, the normal saline test or MRI was used. Intraoperatively, the synovial fistula was repaired with the capsuloligamentous repair or additional periosteal augmentation. All patients had a history of ankle sprain prior to symptoms and showed positive results in the saline load test. One patient had recurred symptom after the surgery, so needed a revisional periosteal augmentation. At 1 year follow-up period, the average Foot ankle outcome score was 87.65 and no surgery-related complication was detected. Synovial fistula of the ankle joint needs to be taken into consideration as a possible complication in patients with ankle sprain history and recurrent joint swelling. The saline load test would be useful for its diagnosis, and treatment should be focused on the complete closure of capsular opening along with restoration of its surrounding pathologic conditions.

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“…Case Reports in Orthopedics Synovial fistula is an uncommon complication (0.61%-0.011% incidence) [2][3][4]. It usually appears through arthroscopy portals, either chronic [5,8] or acute [9]. This complication could present as a fistula if opened to skin [4,9,10] or as a cyst if skin is preserved [5-7, 9, 11-13].…”

mentioning

confidence: 99%

“…It usually appears through arthroscopy portals, either chronic [5,8] or acute [9]. This complication could present as a fistula if opened to skin [4,9,10] or as a cyst if skin is preserved [5-7, 9, 11-13]. Usual locations comprise arthroscopy portals and skin incisions for graft introduction and fixation [4][5][6][7][9][10][11][12][13].…”

mentioning

confidence: 99%

“…This complication could present as a fistula if opened to skin [4,9,10] or as a cyst if skin is preserved [5-7, 9, 11-13]. Usual locations comprise arthroscopy portals and skin incisions for graft introduction and fixation [4][5][6][7][9][10][11][12][13]. Identified risk factors are persistent synovial fluid drainage through tibial bone tunnels [7,11], size mismatch of interference screws and bone tunnels [12], breakage or absorption of interference screws [8,13], inadequate or eccentric bone graft placement [14], graft necrosis [11], interference screw loosening [8], and foreign body reaction [15].…”

mentioning

confidence: 99%

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Late-Onset Recurrent Femoral Cyst Formation 10 Years after ACL Reconstruction: A Case Report and Literature Review

Sánchez-Muñoz

Fernández

Muñiz³

et al. 2020

Case Reports in Orthopedics

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Synovial fistula and cyst formation after anterior cruciate ligament (ACL) reconstruction is very unusual and almost always affects the tibia. Only 3 cases originating in the femur have been reported. We present a rare case of late-onset femoral cyst formation related to ACL reconstruction. Ten years after successful ACL reconstruction surgery, effusion and pain at the lateral aspect of the lateral femoral condyle appeared. Symptoms persisted despite initial percutaneous drainage and conservative treatment. Surgery was carried out, with drainage and graft-fixation pin device removal, with recurrent cyst formation after the intervention. Total recovery of the patient was achieved after carrying out revision surgery consisting in bone tunnel filling using autologous bone graft and occlusion of cortical bone defect with local fascial flap. The development of this unusual complication was related to lack of absorption of the fixation device, bone burn due to drilling, and persistent synovial fluid in the femoral bone tunnel, combined with the absence of bone ingrowth.

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Early postoperative transtibial articular fistula formation after anterior cruciate ligament reconstruction: a review of three cases

Cited by 6 publications

References 24 publications

A comprehensive scoping review of tibial cysts after anterior cruciate ligament reconstruction

A comprehensive scoping review of tibial cysts after anterior cruciate ligament reconstruction

Clinical Manifestations, Diagnosis and Management of Synovial Fistula Associated Lateral Ankle Sprain or Instability: A Retrospective Study of 19 Surgically Confirmed Patients

Late-Onset Recurrent Femoral Cyst Formation 10 Years after ACL Reconstruction: A Case Report and Literature Review

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