A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report
Lateral femoral wall perforation is a rare intra-operative complication in anterior cruciate ligament (ACL) reconstruction surgery. However, it can be challenging to manage if it occurs. We share our experience on lateral femoral wall perforation managed by a large fragment washer. A 25-year-ol...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Malaysian Orthopaedic Association
2020-07-01
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| Series: | Malaysian Orthopaedic Journal |
| Subjects: | |
| Online Access: | https://www.morthoj.org/2020/v14n2/anterior-cruciate-ligament.pdf |
| _version_ | 1818848762151305216 |
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| author | Tan SY Leong WH Ong LH Mohd-Amin MZ |
| author_facet | Tan SY Leong WH Ong LH Mohd-Amin MZ |
| author_sort | Tan SY |
| collection | DOAJ |
| description | Lateral femoral wall perforation is a rare intra-operative
complication in anterior cruciate ligament (ACL)
reconstruction surgery. However, it can be challenging to
manage if it occurs. We share our experience on lateral
femoral wall perforation managed by a large fragment
washer. A 25-year-old man with right ACL injury presented
with knee instability despite physiotherapy. Anterior drawer
test (ADT) and Lachman test were grade 3, glide on pivot
shift was positive. During ACL reconstruction, the lateral
femoral wall was perforated. Due to unavailability of the
rescue endobutton and budget constraint, we passed the
endobutton through a washer and allowed it to sit on the
washer over the lateral femoral wall. ADT and Lachman test
on post-operative 6, 12 and 24 weeks were grade 1, with a
negative pivot shift test. Lysholm knee score improved from
69 pre-operatively to 98 post-operatively. Conventionally,
lateral femoral wall perforation can be managed by rescue
endobutton, or screw and washer post technique. As this
complication is rare, the rescue endobutton may not be
available at all times, and the cost of the implant is also
another important factor to consider. A washer can be used as an alternative technique to manage lateral femoral wall
perforation in ACL reconstruction as it is not only costeffective but also provides stable fixation with good
functional outcome. |
| first_indexed | 2024-12-19T06:22:29Z |
| format | Article |
| id | doaj.art-9bc4d693fcb5400ba4787621b03d0780 |
| institution | Directory Open Access Journal |
| issn | 1985-2533 2232-111X |
| language | English |
| last_indexed | 2024-12-19T06:22:29Z |
| publishDate | 2020-07-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-9bc4d693fcb5400ba4787621b03d07802022-12-21T20:32:39ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2020-07-0114213814010.5704/MOJ.2007.023A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case ReportTan SY0Leong WH1Ong LH2Mohd-Amin MZ3MDMDMDMDLateral femoral wall perforation is a rare intra-operative complication in anterior cruciate ligament (ACL) reconstruction surgery. However, it can be challenging to manage if it occurs. We share our experience on lateral femoral wall perforation managed by a large fragment washer. A 25-year-old man with right ACL injury presented with knee instability despite physiotherapy. Anterior drawer test (ADT) and Lachman test were grade 3, glide on pivot shift was positive. During ACL reconstruction, the lateral femoral wall was perforated. Due to unavailability of the rescue endobutton and budget constraint, we passed the endobutton through a washer and allowed it to sit on the washer over the lateral femoral wall. ADT and Lachman test on post-operative 6, 12 and 24 weeks were grade 1, with a negative pivot shift test. Lysholm knee score improved from 69 pre-operatively to 98 post-operatively. Conventionally, lateral femoral wall perforation can be managed by rescue endobutton, or screw and washer post technique. As this complication is rare, the rescue endobutton may not be available at all times, and the cost of the implant is also another important factor to consider. A washer can be used as an alternative technique to manage lateral femoral wall perforation in ACL reconstruction as it is not only costeffective but also provides stable fixation with good functional outcome.https://www.morthoj.org/2020/v14n2/anterior-cruciate-ligament.pdfaclendobuttonwasherblowout |
| spellingShingle | Tan SY Leong WH Ong LH Mohd-Amin MZ A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report Malaysian Orthopaedic Journal acl endobutton washer blowout |
| title | A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report |
| title_full | A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report |
| title_fullStr | A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report |
| title_full_unstemmed | A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report |
| title_short | A Cost-Effective Alternative for Lateral Femoral Wall Perforation in Anterior Cruciate Ligament (ACL) Reconstruction: A Case Report |
| title_sort | cost effective alternative for lateral femoral wall perforation in anterior cruciate ligament acl reconstruction a case report |
| topic | acl endobutton washer blowout |
| url | https://www.morthoj.org/2020/v14n2/anterior-cruciate-ligament.pdf |
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