Intraoperative fracture of patellar bone plug during anterior cruciate ligament reconstruction with bone–patellar tendon–bone: clinical case

Abstract

The authors report the case of intraoperative fracture of the patellar bone plug during an operation to reconstruct an anterior cruciate ligament using bone-patellar tendon-bone. This complication, known among the problems of reconstructing the anterior cruciate ligament, is usually reported when using interference screws to block the plug at the femoral level. In the case, we describe the fracture event occurred using cross-pins. The post-operative 3D radiographic reconstruction permitted precise localisation of the position of the detached bone fragment.

Management of Intraoperative Complications in Arthroscopic Primary Anterior Cruciate Ligament Reconstruction

“…The bone block of the BPTB graft is drilled to allow suture passage to pull the graft through the tibial and femoral tunnels. Bone block fracture may occur 16 during drilling the suture holes, bone block harvesting, or insertion of the graft into the tunnels. This complication may be managed by placing a whipstitch into the adjacent part of the patellar tendon to pull the graft into the tibial and femoral tunnels (►Fig.…”