Anterior cruciate ligament (ACL) reconstruction complications are common, occurring in 10-25% of patients.
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Clinical presentation
Patients with complications of ACL reconstruction can present with decreased range of motion (impingement or arthrofibrosis) and/or laxity (graft rupture or stretching) 2.
Pathology
Complications include 1-3:
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decreased range of motion
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femoral or tibial tunnel cyst
more common on the tibial side
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post-operative laxity: occurs in 1-8% of patients 3
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acute or chronic: in chronic rupture the graft is not visible on MRI due to resorption over time
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miscellaneous
fixation material complication: e.g. migration, displacement, fragmentation, screw extrusion
inflammatory reaction/rejection
infection
tunnel osteolysis: defined as tunnel widening >14 mm; may require two-stage revision ACL reconstruction 5
septic arthritis: ~0.5% (range 0.1-0.9%)
retractile capsulitis
donor tendon complication: e.g. rupture, shortening
vascular complications: e.g. inferior geniculate artery pseudoaneurysms at donor tendon sites
stress fractures: more common on the femoral side
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