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WORST CASE SCENARIO

A Really Serious Complication?!

Prof Adj Dr. Daniel Slullitel

Instituto Slullitel Ortopedia y Trauma
Universidad Abierta Inteamericana

Rosario, ARGENTINA

03 04

In 2007 a woman police officer came to my office with a long At that point she returned to my office with her husband very

history of previous knee surgeries following a motorcycle worried. The reason was unexpected: she was pregnant and
accident in 2004. Her first surgery was PCL reconstruction conception date was calculated to be around her surgery. She
surgery (Image 1), second was ACL plus PCL revision surgery was concerned about the risks of the drugs used following the

a year later.
procedure. She reported on taking contraceptives regularly
and did not know what was the cause of it’s failure.
At present she still has symptoms of instability during daily
activities.
So we went through the full list of drugs she has taken. One

Examination revealed posterolateral deficient corner and of the drugs administered was rifampicin used as prophylactic
agent, as suggested by the our infectious surveillance hospital
anteroposterior laxity. The MRI showed signs of lateral collateral
ligament tear plus abnormal signs of the reconstructed ACL team. I have learned, albeit late. that it interferes with the
contraceptives being a probable cause of the unexpected
and the re reconstructed PCL (Image 2).
pregnancy.
We decided to proceed with a Posterolateral Corner
Reconstruction with allograft in an Ellyson type reconstruction I spent the next six months worrying, charging the weight of
that medicine use, and the probability of potential intra uterine
plus an ACL Revision with Achilles allograft, leaving the
twice-reconstructed PCL as is, because it seems stable. defects.

Post surgery she was 45 days with splints and crutches, Fortunately that was not the case. Her surgery result remained
non weight bearing. After formal rehab, at three months, she satisfactory till this very date, and so mother and son (Image
reached normal gait and good flexion-extension.
3 and 4).

If I can make one

recommendation to

my fellow surgeons..

Do you know the interactions

of all the drugs you use?

Do you know the

interactions of the drugs

01
that others make you use?

Do you know the interactions

of the drugs that your patients

use in a daily basis?

01 Rx First Pcl surgery
02 MRI showing deficient ACL and doubtful PCL with artifacts because of
the quantity of fixation devices
03 Standing Xr at 7 years

04 Mother and Son
02

42 ISAKOS NEWSLETTER 2014: Volume II