# Intra-articular Migration of a Broken Needle in an Intravenous Drug User: A Case Report and Surgical Management

## TL;DR

A 29-year-old intravenous drug user had a broken needle migrate into his knee joint, requiring surgery for removal to prevent joint damage.

## Contribution

This case report presents a rare instance of intra-articular needle migration in an IV drug user and emphasizes surgical strategies for retrieval.

## Key findings

- A broken needle migrated into the knee joint after failed initial removal attempts.
- Intraoperative imaging and surgical exploration were essential for locating and retrieving the needle.
- Early diagnosis and intervention are critical to prevent joint damage and complications.

## Abstract

Intravenous drug users (IVDUs) frequently present with complications; however, intra-articular migration of a broken needle is exceedingly rare.

This is the case of a 29-year-old male heroin user who experienced needle breakage during self-injection into the popliteal fossa. The initial removal attempts failed, and he presented with knee discomfort 10 days later. Radiographs revealed a metallic foreign body in the popliteal fossa, near the femur. Posterior surgical exploration failed to locate the needle. Intraoperative imaging showed anterior migration. A medial parapatellar arthrotomy was performed, and the needle was retrieved between the anterior cruciate ligament (ACL) and the lateral meniscus. This case highlights the importance of intraoperative imaging and surgical flexibility. Early diagnosis and retrieval are crucial for avoiding joint damage and complications.