Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2025; 13(23): 105003
Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.105003
Broken bioabsorbable tibial interference screw post-arthroscopic anterior cruciate ligament reconstruction: A case report
Mainak Roy, Suhas Aradhya Bhikshavarthi Math, Deepanjan Das, Samir Dwidmuthe
Mainak Roy, Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Bhubaneshwar 751019, Odisha, India
Suhas Aradhya Bhikshavarthi Math, Deepanjan Das, Samir Dwidmuthe, Department of Orthopaedics, All India Institute of Medical Sciences Nagpur, Nagpur 441108, Maharashtra, India
Author contributions: Roy M and Bhikshavarthi Math SA were responsible for conceptualization and data acquisition; Roy M and Das D were responsible for manuscript writing; Roy M and Dwidmuthe S were responsible for supervision; Das D and Dwidmuthe S were responsible for manuscript revision; all authors have agreed to the final version to be published and agree to be accountable for all aspects of the work.
Informed consent statement: Informed consent statement was obtained from patient and relatives.
Conflict-of-interest statement: Authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mainak Roy, Senior Resident, Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Sijua, Patrapada, Bhubaneshwar 751019, Odisha, India. mainakroy30@gmail.com
Received: January 9, 2025
Revised: April 6, 2025
Accepted: April 23, 2025
Published online: August 16, 2025
Processing time: 146 Days and 23.9 Hours
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.

Keywords: Bioabsorbable interference screws; Anterior cruciate ligament reconstruction; Screw breakage; Arthroscopy; Anterior cruciate ligament tear; Case report

Core Tip: This case report highlights the rare complication of bioabsorbable tibial interference screw breakage and intra-articular migration following anterior cruciate ligament (ACL) reconstruction. It underscores the importance of meticulous surgical technique, vigilant postoperative monitoring, and timely intervention to manage such complications effectively. Therapeutic arthroscopy ensured intact graft function and successful removal of screw fragments, enabling the patient to resume normal activities. A comprehensive literature review elaborates on risk factors, mechanisms, and preventive strategies for complications associated with bioabsorbable screws, contributing valuable insights to improve patient outcomes in ACL reconstruction procedures.