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The Journal of Bone and Joint Surgery 82:1454 (2000)
© 2000 The Journal of Bone and Joint Surgery, Inc.

Case Report

Autodigestion of a Hamstring Anterior Cruciate Ligament Autograft Following Thermal Shrinkage

A Case Report and Sentinel of Concern*

Jon K. Sekiya, M.D.{dagger}, Gregory J. Golladay, M.D.{dagger} and Edward M. Wojtys, M.D.{ddagger}

Investigation performed at the University of Michigan Medical Center, Ann Arbor, Michigan
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study.
{dagger}Section of Orthopaedic Surgery, University of Michigan Medical Center, 1500 East Medical Center Drive, TC 2912/0328, Ann Arbor, Michigan 48109-0328. The e-mail address for J. K. Sekiya is sekiya@med.umich.edu. Please address requests for reprints to J. K. Sekiya.
{ddagger}Section of Orthopaedic Surgery, MedSport, University of Michigan Medical Center, 24 Frank Lloyd Wright Drive, P.O. Box 363, Ann Arbor, Michigan 48106-0363. The e-mail address for E. M. Wojtys is edwojtys@med.umich.edu.


   Introduction
 
Thermal and laser heat shrinkage of collagen recently has been proposed as a means of treating selected cases of shoulder instability12. While such treatment is controversial, clinical reports of capsular shrinkage procedures involving the shoulder have shown limited but promising results1,2,9,10. Thermal technology also has been applied to the treatment of anterior cruciate ligament laxity in the knee11. Basic-science investigators have elucidated the macroscopic and molecular changes that occur in the collagen fibrils following thermal shrinkage3-7. However, long-term clinical follow-up to determine the integrity of these structures following thermal shrinkage is still lacking.

We present the case of a patient in whom an endoscopic reconstruction of the anterior cruciate ligament was performed with a hamstring autograft, which, following reinjury, underwent thermal shrinkage. The findings at arthroscopy, both during the initial thermal shrinkage and at fifteen weeks postoperatively, are discussed.


   Case Report
 
A sixteen-year-old female athlete sustained an anterior . . . [Full Text of this Article]


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