{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T22:25:01Z","timestamp":1789424701025,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 29-year-old man presented 2 years after anterior cruciate ligament (ACL) reconstruction by autologous semitendinosus graft and suspensory fixation on both tibial and femoral sides for chronic drainage of clear fluid from an anteromedial wound at the site of the tibial tunnel with a visible sinus tract. Magnetic resonance imaging showed a transtibial articulocutaneous fistula. The patient was treated by tunnel debridement, impaction bone grafting, bioresorbable interference screw, and cement to fully seal the tunnel. The surgery was successful with good clinical outcomes for recurrence and knee stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Communicating transtibial articulocutaneous fistulas are rare complications after ACL reconstruction. Tunnel debridement and filling with graft material affected by an interference screw seem to be an effective method for dealing with such a clinical scenario.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.22.00159","type":"journal-article","created":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T08:15:38Z","timestamp":1661847338000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Management of Chronic Transtibial Articulocutaneous Fistula After All-Inside ACL Reconstruction"],"prefix":"10.2106","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8881-8904","authenticated-orcid":false,"given":"Mohammad O.","family":"Boushnak","sequence":"first","affiliation":[{"name":"The Department of Orthopedic Surgery, Lebanses Military Hospital, Beirut, Lebanon"},{"name":"Universit\u00e9 Libre de Bruxelles, Faculty of Medicine, Department of Orthopedic Surgery, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2611-3938","authenticated-orcid":false,"given":"Mohamad K.","family":"Moussa","sequence":"additional","affiliation":[{"name":"The Department of Orthopedic Surgery, Grand Hospital de l\u2019Est Francilien, Meaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0867-4275","authenticated-orcid":false,"given":"Ali","family":"Alayane","sequence":"additional","affiliation":[{"name":"The Department of Orthopedic Surgery, Grand Hospital de l\u2019Est Francilien, Meaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6356-4645","authenticated-orcid":false,"given":"Hamlet","family":"Mirzoyan","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Libre de Bruxelles, Faculty of Medicine, Department of Orthopedic Surgery, Brussels, Belgium"},{"name":"Department of Orthopedics and Traumatology, ULB Erasme University Hospital, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8055-3737","authenticated-orcid":false,"given":"Samer","family":"Hajjar","sequence":"additional","affiliation":[{"name":"The Department of Orthopedic Surgery, Lebanses Military Hospital, Beirut, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,7]]},"reference":[{"issue":"19","key":"bib1-20240805","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.2106\/JBJS.L.01705","article-title":"Societal and economic impact of anterior cruciate ligament tears","volume":"95","author":"Mather","year":"2013","journal-title":"J Bone Joint Surg Am."},{"issue":"10","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.1177\/0363546512457348","article-title":"The Swedish national anterior cruciate ligament register: a report on baseline variables and outcomes of surgery for almost 18,000 patients","volume":"40","author":"Ahlden","year":"2012","journal-title":"Am J Sports Med."},{"issue":"1","key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0749-8063(00)90126-9","article-title":"A new bioabsorbable interference screw: preliminary results of a prospective, multicenter, randomized clinical trial","volume":"16","author":"Benedetto","year":"2000","journal-title":"Arthroscopy."},{"issue":"1","key":"bib4-20240805","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0968-0160(01)00109-0","article-title":"Tibial cyst formation after anterior cruciate ligament reconstruction using a new bioabsorbable screw","volume":"9","author":"Malhan","year":"2002","journal-title":"Knee."},{"issue":"4","key":"bib5-20240805","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.csm.2007.06.003","article-title":"Allograft safety in anterior cruciate ligament reconstruction","volume":"26","author":"Cohen","year":"2007","journal-title":"Clin Sports Med."},{"issue":"7","key":"bib6-20240805","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1148\/rg.297095036","article-title":"MR imaging of complications following anterior cruciate ligament graft reconstruction","volume":"29","author":"Bencardino","year":"2009","journal-title":"Radiographics."},{"key":"bib7-20240805","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1007\/s00256-012-1486-2","article-title":"Tibial tunnel and pretibial cysts following ACL graft reconstruction: MR imaging diagnosis","volume":"4111","author":"Ghazikhanian","year":"2012","journal-title":"Skeletal Radiol."},{"key":"bib8-20240805","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00264-006-0118-7","article-title":"Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study","volume":"31","author":"Iorio","year":"2007","journal-title":"Int Orthop."},{"issue":"3","key":"bib9-20240805","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/S0749-8063(99)70042-3","article-title":"Tibial and pretibial cyst formation after anterior cruciate ligament reconstruction with bioabsorbable interference screw fixation","volume":"15","author":"Martinek","year":"1999","journal-title":"Arthroscopy."},{"issue":"1","key":"bib10-20240805","doi-asserted-by":"crossref","first-page":"79","DOI":"10.3928\/0147-7447-20020101-22","article-title":"Pretibial cyst following anterior cruciate ligament reconstruction using hamstring autografts","volume":"25","author":"Brager","year":"2002","journal-title":"Orthopedics."},{"issue":"12","key":"bib11-20240805","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1016\/j.arthro.2011.06.036","article-title":"Resorption and remodeling of hydroxyapatite-poly-l-lactic acid composite anterior cruciate ligament interference screws","volume":"27","author":"Johnston","year":"2011","journal-title":"Arthroscopy."},{"issue":"2","key":"bib12-20240805","doi-asserted-by":"crossref","first-page":"E5","DOI":"10.1053\/jars.2003.50045","article-title":"Pretibial cyst formation after arthroscopic anterior cruciate ligament reconstruction","volume":"19","author":"Ilahi","year":"2003","journal-title":"Arthroscopy."},{"key":"bib13-20240805","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0749-8063(98)70044-1","article-title":"Pretibial cyst formation after anterior cruciate ligament surgery with soft tissue autografts","volume":"14","author":"Simonian","year":"1998","journal-title":"Arthroscopy."},{"key":"bib14-20240805","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00167-007-0388-7","article-title":"Rejection reaction to stabilizing bolts after ACL reconstruction: a case report","volume":"16","author":"Lamprakis","year":"2008","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"key":"bib15-20240805","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1016\/0749-8063(95)90206-6","article-title":"Subcutaneous pretibial cyst formation associated with anterior cruciate ligament allografts: a report of four cases and literature review","volume":"11","author":"Victoroff","year":"1995","journal-title":"Arthroscopy."},{"issue":"6","key":"bib16-20240805","doi-asserted-by":"crossref","first-page":"691.e1","DOI":"10.1016\/j.arthro.2005.04.115","article-title":"Pretibial cyst formation after anterior cruciate ligament reconstruction with a hamstring tendon autograft","volume":"22","author":"Tsuda","year":"2006","journal-title":"Arthroscopy."},{"key":"bib17-20240805","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S0730-725X(00)00207-1","article-title":"Pretibial cyst formation after anterior cruciate ligament reconstruction using auto hamstring grafts: two case reports in a prospective study of 89 cases","volume":"18","author":"Deie","year":"2000","journal-title":"Magn Reson Imag."},{"key":"bib18-20240805","doi-asserted-by":"crossref","first-page":"1082","DOI":"10.1007\/s11999-010-1580-5","article-title":"Is the etiology of pretibial cyst formation after absorbable interference screw use related to a foreign body reaction?","volume":"469","author":"Gonzalez-Lomas","year":"2011","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib19-20240805","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1097\/00004728-200207000-00025","article-title":"Fluid collections in the osseous tunnel during the first year after anterior cruciate ligament repair using an autologous hamstring graft: natural history and clinical correlation","volume":"26","author":"Sanders","year":"2002","journal-title":"J Comput Assist Tomogr."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:18Z","timestamp":1787751858000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00159"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.22.00159","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}