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Osteolysis-Related Bioabsorbable Suture Anchor Fixation in a Medial Collateral Ligament Avulsion Fracture during Total Knee Arthroplasty

슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 발생한 골용해

  • Received : 2019.08.30
  • Accepted : 2019.10.15
  • Published : 2020.12.30

Abstract

Although rare, the treatment options for a medial collateral avulsion fracture during total knee arthroplasty (TKA) range from conservative management using a cast and orthosis to internal fixation using metal screws. Bioabsorbable suture anchors have been used to replace metal fixators with distinct advantages, such as biocompatibility, radiolucency, and unnecessary second removal surgery, but complications, such as osteolysis, have been reported. This paper reports a potential risk of an extensive osteolysis-related suture anchor fixation of a medial collateral ligament (MCL) avulsion fracture during TKA in conjunction with a literature review.

슬관절 인공관절 치환술 중 드물게 발생하는 내측 측부 인대 견열 골절의 치료는 보조기나 캐스트 등의 보존적 치료, 금속 나사못을 이용한 고정 등의 다양한 치료법이 소개되고 있다. 생흡수성 봉합 나사못은 생체 적합성, 방사선 투과성, 제거를 위한 2차 수술이 불필요하다는 장점 등으로 여러 부위에서 금속 고정물을 대체해 사용되고 있으나 골용해 등의 합병증이 보고되고 있다. 저자들은 슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 심각한 골용해 소견을 경험하여 사용에 신중을 기해야 한다는 판단하에 이에 대한 문헌 고찰과 함께 보고하고자 한다.

Keywords

References

  1. Sawyer GA, Anderson BC, Paller D, Schiller J, Eberson CP, Hulstyn M. Biomechanical analysis of suture bridge fixation for tibial eminence fractures. Arthroscopy. 2012;28:1533-9. https://doi.org/10.1016/j.arthro.2012.02.020
  2. Lee KW, Yang DS, Lee GS, Choy WS. Suture bridge fixation technique for posterior cruciate ligament avulsion fracture. Clin Orthop Surg. 2015;7:505-8. https://doi.org/10.4055/cios.2015.7.4.505
  3. Bateman DK, Barlow JD, VanBeek C, Abboud JA. Suture anchor fixation of displaced olecranon fractures in the elderly: a case series and surgical technique. J Shoulder Elbow Surg. 2015;24:1090-7. https://doi.org/10.1016/j.jse.2015.02.017
  4. Naggar L. Surgical management of comminuted, displaced greater tuberosity fractures: a new technique of subacromial spacer on top of double-row suture anchor fixation. Joints. 2018;6:211-4. https://doi.org/10.1055/s-0038-1675162
  5. Galano GJ, Jiang KN, Strauch RJ, Rosenwasser MP, Tang P. Inflammatory response with osteolysis related to a bioabsorbable anchor in the finger: a case report. Hand (N Y). 2010;5:307-12. https://doi.org/10.1007/s11552-009-9240-5
  6. Dal Molin FF. Extensive osteolysis after the use of a bioabsorbable suture anchor: case report and literature review. Rev Bras Ortop. 2015;45:493-6. https://doi.org/10.1590/S0102-36162010000500020
  7. Della Torre PK, Stephens A, Oh HL, Kamra A, Zicat B, Walker P. Management of medial collateral ligament injury during primary total knee arthroplasty: a systematic review. JISRF Reconstructive Review. 2014;4:17-23. https://doi.org/10.15438/rr.v4i2.69
  8. Bohl DD, Wetters NG, Del Gaizo DJ, Jacobs JJ, Rosenberg AG, Della Valle CJ. Repair of intraoperative injury to the medial collateral ligament during primary total knee arthroplasty. J Bone Joint Surg Am. 2016;98:35-9. https://doi.org/10.2106/JBJS.O.00721