Year: 2026 | Month: September | Volume: 13 | Issue: 9 | Pages: 424-431
DOI: https://doi.org/10.52403/ijrr.20260939
Evacuation Per Arthroscopy of Wire Migration Following of Broken Patella Cerclage Wire: A Case Report
Seva Ajisma1, Andini Febriana1, IGN Wien Aryana2, I Komang Mahendra Laksana3, Komang Septian Sandiwidayat2, Gede Mahardika Putra2
1Resident, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
2Orthopaedic Surgeon, Dept. Orthopaedic & Traumatology, Prof IGNG Ngoerah General Hospital, Udayana University, Bali, Indonesia
3Orthopaedic Sports Injury Consultant Dept. Orthopaedic & Traumatology, Wangaya General Hospital, Bali, Indonesia
Corresponding Author: Seva Ajisma
ABSTRACT
Background: Patellar fractures account for roughly 1% of all bone injuries and are often treated surgically in cases of displacement or articular incongruity. Cerclage wiring is a prevalent fixation method because to its straightforwardness and efficacy in attaining fracture stability. Nonetheless, problems including hardware loosening, fracture, and migration have been documented, especially in long-term assessments. Intra-articular wire migration is an uncommon although potentially severe consequence that may result in joint discomfort, mechanical symptoms, and cartilage destruction. Arthroscopic extraction of displaced wires has become a minimally invasive and secure alternative to open surgeries.
Case Presentation: We present the case of a 56-year-old male with a history of a right patellar fracture, which was managed with open reduction and internal fixation utilising cerclage wiring two years ago. The patient had growing anterior knee pain for one month, worsened by walking and ascending stairs. The physical examination indicated localised pain over the anterior patella, absent of oedema or deformity. Radiographic imaging revealed wire loosening, and intraoperative fluoroscopy verified the migration of a wire piece into the intra-articular area. The patient successfully had arthroscopic wire removal, with no injury to the articular cartilage seen. The postoperative recovery was unremarkable, and early mobilisation with physiotherapy led to substantial functional enhancement.
Discussion: This case exemplifies the postponed manifestation of intra-articular wire migration, a rare yet clinically pertinent consequence of cerclage fixation. Prior research has highlighted the significance of diligent monitoring and the evaluation of elective implant removal to avert such occurrences. Arthroscopy provides a precise and minimally invasive method for implant retrieval, yielding favourable results.
Conclusion: Orthopaedic surgeons must remain vigilant for hardware migration in patients exhibiting late-onset joint problems after fixation. Timely intervention with arthroscopic methods guarantees superior results with reduced morbidity.
Keywords: Patellar fracture, cerclage wire, hardware migration, arthroscopy, knee joint, implant failure.
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