Portal de Periódicos da CAPES

Complications of anterior cruciate ligament reconstruction

1992; Elsevier BV; Volume: 2; Issue: 2 Linguagem: Inglês

10.1016/s1048-6666(06)80096-0

1558-3848

Howard R. Brown, Peter A. Indelicato,

Tendon Structure and Treatment

Despite meticulous care, complications can occur following anterior cruciate ligament (ACL) reconstruction of the knee. The central third of the patella tendon is the most common graft used to reconstruct the ACL. Patella fractures, tendon ruptures, and postoperative “donor site” tendinitis can occur. Other sources of graft material, both synthetic and biologic, each have specific potential problems. As far as technique is concerned, an overaggressive notchplasty should be avoided. The attachment site drill holes need to be carefully placed in order to avoid unrecognized fractures. Sharp edges at the exit site of the drill holes should be chamfered. Graft tension and fixation should be carefully checked by appropriate loading. A painful stiff knee can result from the presence of arthrofibrosis and/or reflex sympathetic dystrophy. Early recognition and an aggressive approach is the only chance to avoid a major permanent disability. The most successful way to avoid postoperative complications of ACL reconstruction is to adhere to the well-established basic principles, ie, recreation of the anatomical attachment sites, adequate intercondylar notch decompression, and excellent graft fixation in order to safely allow early full motion of the knee.