J Korean Orthop Assoc.  2007 Dec;42(6):836-839. 10.4055/jkoa.2007.42.6.836.

Heterotopic Bone Formation in Patient who Underwent a Posterior Cruciate Ligament Reconstruction using the Inlay Method and Posterolateral Corner Sling with a Tibia Tunnel: A Case Report

Affiliations
  • 1The Armed Forces Yangju Hospital, Yangju, Korea.
  • 2Department of Orthopedic Surgery, Chung-Ang University Medical Center, Seoul, Korea. jungyb2000@paran.co.kr

Abstract

We describe a case of posterolateral capsular heterotopic ossification requiring a surgical excision after a PCL (Posterior Cruciate Ligament) reconstruction using the modified inlay method and PLCS (posterolateral corner sling) with a tibia tunnel. A 21-year-old female patient had suffered a blunt proximal tibial direct trauma 6 months earlier. She did not experience limb ischemia or a pulse deficit before she visited our out patient clinic. She had not suffered any trauma in other sites, and showed a range of motion of 0 to 30degrees at 4 months after surgery. There was no specific finding on the X-ray images. Arthroscopic adhesiolysis was performed and her range of motion increased to 0 to 120degrees. However, 6 months after the initial operation, she showed ankylosis and heterotopic ossification at the posterior aspect, which was surgically removed at 12 months postoperatively. After the second surgery, there was no recurrence and she showed a 0 to 140degrees range of motion at postoperative 42 months.

Keyword

Posterior cruciate ligament reconstruction; Posterolateral corner sling; Adhesiolysis; Heterotopic ossification

MeSH Terms

Ankylosis
Extremities
Female
Humans
Inlays*
Ischemia
Ossification, Heterotopic
Osteogenesis*
Posterior Cruciate Ligament*
Range of Motion, Articular
Recurrence
Tibia*
Young Adult

Figure

  • Fig. 1 The stress lateral view of a grade III posterior instability.

  • Fig. 2 The roentgenograms 6 months after surgery showing supracondylar heterotopic ossification.

  • Fig. 3 The stress lateral view of 30 months after the excision operation showing no recurrence of heterotopic ossification and good stability of the PCL.


Reference

1. Albright JP, Brown AW. Management of chronic posterolateral rotatory instability of the knee: surgical technique for the posterolateral corner sling procedure. Instr Course Lect. 1998. 47:369–378.
2. Charnley G, Judet T, Garreau de Loubresse C, Mollaret O. Excision of heterotopic ossification around the knee following brain injury. Injury. 1996. 27:125–128.
Article
3. Dalury DF, Jiranek WA. The incidence of heterotopic ossification after total knee arthroplasty. J Arthroplasty. 2004. 19:447–452.
Article
4. Ippolito E, Formisano R, Farsetti P, Caterini R, Penta F. Excision for the treatment of periarticular ossification of the knee in patients who have a traumatic brain injury. J Bone Joint Surg Am. 1999. 81:783–789.
Article
5. Jung YB, Jung HJ, Tae SK, Lee YS, Lee KH. Reconstruction of the posterior cruciate ligament with a mid-third patellar tendon graft with use of a modified tibial inlay method. J Bone Joint Surg Am. 2005. 87:Suppl 1. S247–S263.
Article
6. Jung YB, Tae SK, Jung HJ, Lee KH. Replacement of the torn posterior cruciate ligament with a mid-third patellar tendon graft with use of a modified tibial inlay method. J Bone Joint Surg Am. 2004. 86:1878–1883.
Article
7. Patton WC, Tew WM. Periarticular heterotopic ossification after multiple knee ligament reconstructions. A report of three cases. Am J Sports Med. 2000. 28:398–401.
8. Saito N, Horiuchi H, Takahashi H. Heterotopic ossification in the knee following encephalitis: a case report with a 10-year follow-up. Knee. 2004. 11:63–65.
Article
9. Stannard JP, Wilson TC, Sheils TM, McGwin G Jr, Volgas DA, Alonso JE. Heterotopic ossification associated with knee dislocation. Arthroscopy. 2002. 18:835–839.
Article
10. Toyoda T, Matsumoto H, Tsuji T, Kinouchi J, Fujikawa K. Heterotopic ossification after total knee arthroplasty. J Arthroplasty. 2003. 18:760–764.
Article
Full Text Links
  • JKOA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr