Surgical technique of creation of valve mechanism with free fascia lata graft for closure of a synovial fistula of knee

Abstract

Synovial fistulae associated with large defects in capsulo-synovial envelope have been reported rarely, mostly after surgeries or infections. Unlike post arthroscopy synovial fistulae, which may be treated with immobilisation with or without direct repair, surgical obliteration of defect and track is essential for healing of such synovial fistulae. Technical aspect of obliteration emphasized in literature is watertight tensionless closure of the defect. We report surgical technique of closure of one such synovial fistula with Free Fascia Lata Graft with an inbuilt valve mechanism to reduce chances of recurrence. Watertightness of closure was demonstrated intraoperatively by instilling saline under pressure in the joint. Healing of free fascia lata graft with capsular tissue with valve mechanism persistently demonstrable at a follow up of more than three year is shown.