Flashback Friday: The mystery of the bottle cap in the knee.



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Photo: flickr/Arria Belli

It's not news that sometimes stuff gets lost inside a body, either from a traumatic event or during surgery (sponges are the most common forgotten item, but clamps, scissors, and other horrifying instruments have also been left behind). Here's a more unusual case study that involves a plastic bottle cap. Left inside a patient. For six months! It's unclear whether the bottle cap got there during a motorcycle accident (sneaking by unseen during surgery), or if it was somehow introduced during the surgery. Either way, it's... unsettling.

Arthroscopic removal of a plastic soft drink bottle cap in the knee: a case report. “We report a rare case of late knee locking after an open knee injury in a polytrauma patient with a pelvic fracture and a contralateral femoral artery injury. Once the life and limb threatening injuries were addressed, debridement and washout of the knee wound was performed. X-rays and subsequent CT revealed only an undisplaced patella fracture. The patient presented 6 months later to a knee surgeon with recurrent locking. An arthroscopy was performed and a 10 mm plastic soft drink bottle cap was retrieved leading to the immediate resolution of symptoms without complications. Open knee injuries require thorough debridement washout and joint assessment. Late locking should raise the suspicion of an intra-articular loose or foreign body. Arthroscopy is an excellent first line tool in the diagnosis and late management of this unusual problem." Related content: Discoblog: NCBI ROFL: The novel use of wooden spoons for control of massive intra-abdominal hemorrhage. Discoblog: NCBI ROFL: Self-surgery: not for the faint of heart. Discoblog: NCBI ROFL: Are full or empty beer bottles sturdier and does their fracture-threshold suffice to break the human skull?

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