CC BY-NC-ND 4.0 · Joints 2018; 06(03): 188-203
DOI: 10.1055/s-0038-1675799
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Uncommon Complications after Anterior Cruciate Ligament Reconstruction

Anna Palazzolo
1  Department of Orthopedics and Traumatology, Università degli studi di Torino, Turin, Italy
,
Federica Rosso
2  Department of Orthopaedics and Traumatology, AO Ordine Mauriziano, Turin, Italy
,
Davide Edoardo Bonasia
2  Department of Orthopaedics and Traumatology, AO Ordine Mauriziano, Turin, Italy
,
Francesco Saccia
3  Orthopaedics and Traumatology Unit, San Giovanni Bosco Hospital, Turin, Italy
,
Roberto Rossi
2  Department of Orthopaedics and Traumatology, AO Ordine Mauriziano, Turin, Italy
,
Knee Committee SIGASCOT› Author Affiliations
Further Information

Publication History

15 January 2018

07 October 2018

Publication Date:
30 November 2018 (eFirst)

  

Abstract

Anterior cruciate ligament reconstruction (ACL-R) is a common surgical procedure, with good outcome in 75 to 97% of the cases. However, different complications have been described including infection, hemarthrosis, deep vein thrombosis (DVT), and pulmonary embolism (PE) with a rate ranging from 1 to 15%. There are few case reports in the literature describing rare complications after ACL-R and they can be divided into: (1) complications related to the fixation device (rupture, migration); (2) fractures (tibial or femoral side); (3) infections due to uncommon bacteria, mycobacterium, and mycosis; (4) rare vascular injuries; (5) nerve injuries; and (6) other rare complications. In case of fixation device rupture or migration, device removal can be easy but the diagnosis may be challenging. Patellar fracture after ACL-R may be related to harvesting and it is not uncommon. Conversely, femoral or tibial fractures are most frequently due to bone weakness related to bone tunnels. Some rare infections related to uncommon bacteria or mycosis are also described with potentially devastating joint damage. Popliteal artery injuries are uncommon in ACL-R but minor vessels damages are described with possible severe consequences for patients. Injuries to the infrapatellar branch of the saphenous nerve are not uncommon in ACL-R. However, there are few case reports also describing injuries to the saphenous nerve, the common peroneal nerve and the sciatic nerve. The aim of this paper is to review the literature describing uncommon complications after ACL-R, giving some more information about diagnosis and treatment.