Gossypiboma - knee

Case contributed by Maulik S Patel
Diagnosis certain

Presentation

Anterior cruciate ligament reconstruction about 8 weeks prior to the presentation. Presented with complaints of medial proximal leg mild pain, swelling, and redness for the last few days. No fever.

Patient Data

Age: 25 years
Gender: Male
ultrasound

Absent Semitendinosus and gracilis tendons as they were used as a graft for anterior cruciate ligament reconstruction. The gracilis tendon is replaced by a linear anechoic cleft. An elongated (about 48 mm long), irregular-shaped echogenic area replacing the semitendinosus location along with a strong acoustic shadow. It is surrounded by a hypoechoic soft-tissue rim without a large local collection. A small Baker's cyst with its neck between the semimembranosus and the medial head of the gastrocnemius muscle. There is no collection at the tibial tunnel site. The was no effusion in the suprapatellar recess of the knee joint.

Photo

A photo showed retrieved surgical gauze from the site of knee swelling. It was surrounded by thick granulation tissue without pus formation.

Case Discussion

The case shows graft site gossypiboma of the knee region after anterior cruciate ligament reconstruction. There was no knee joint infection. ACL reconstruction was satisfactory at a one-year follow-up.

 

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