25dkou426
10.3205/25dkou426
urn:nbn:de:0183-25dkou4261
Meeting Abstract
Residual suture materials are associated with severe histomorphological changes in failed anterior cruciate ligament grafts
Siemoneit
Siemoneit
Steffen
S
Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Deutschland
author
Ubl
Ubl
Steffen
S
Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Deutschland
author
Pfeiffer
Pfeiffer
Thomas
T
Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Deutschland
author
Wehrmann
Wehrmann
Julius
J
Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Deutschland
author
Bouillon
Bouillon
Bertil
B
Department of Orthopaedic Surgery, Trauma Surgery and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Cologne, Deutschland
author
Bosse
Bosse
Alexander
A
Department of Pathology, Klinikum Stuttgart, University of Tübingen, Stuttgart, Deutschland
author
German Medical Science GMS Publishing House
Düsseldorf
610
20251031
engl
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung).
M0634
426
Deutsche Gesellschaft für Orthopädie und Unfallchirurgie
Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie
Deutsche Gesellschaft für Unfallchirurgie
Berufsverband für Orthopädie und Unfallchirurgie
Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2025)
Abstracts | Kniechirurgie
Berlin
20251028
20251031
AB66-4624
TextObjectives and questions: The aim of this study was to evaluate the morphological changes and their implications resulting from the utilization of foreign material during anterior cruciate ligament (ACL) reconstruction. It was hypothesized that suture material remnants act as a pathological factor, directly provoking regression phenomena in both ligamentous and bony compartments of the knee joint.Material and methods: In this prospective study, a total of 43 consecutive patients undergoing revision surgery for graft failure after autologous ACL reconstruction were analyzed. The specimens were redrilled with a hollow drilling machine to obtain the entire drill canal and then examined histopathologically after staining with haematoxylin and eosin (HE), Masson-Goldner and Elastika-Gieson stains to characterize morphological changes due to the presence of foreign material, both qualitatively and quantitatively by light microscopy.Results: A total of 68 bone blocks were harvested from 43 patients (9 female, 34 male) with a mean age of 29.7 years, standard deviation: 9.02 (8–58 years). Histomorphological analysis revealed significant degenerative changes in the area of residual suture materials. The degenerative changes observed included intense inflammatory reactions, necrotic alterations, fissure defects and cyst formation. In certain instances, the degradation of the graft was almost total, manifesting as severe cystic changes. The qualitative characteristics of the foreign body reactions demonstrate that direct reactions to the underlying foreign material were observed in 92.6% of the specimens analyzed.Discussion and conclusions: The findings confirm that residual suture materials are associated with severe histomorphological changes in failed ACL grafts. These changes may weaken or compromise graft resilience, contributing to graft failure. The observed pathology was characterized by inflammatory reactions, osteonecrosis, and cyst formation. The results suggest that residual suture material plays a critical role in pathological regression and destructive alterations of autologous tendon grafts following ACL reconstruction. These findings support the recommendation to minimize excessive suture material use in future surgical procedures to reduce the risk of graft failure.
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