Avoiding and Managing Complications in ACL Reconstruction

Despite all the care and precision taken in diagnosing the injury and deciding the best approach, situations arise that cannot always be anticipated. The following sections describe an array of complications, their remedies, and certain precautions that will assist in preventing such occurrences.The timing of surgery has been a factor in determining range of motion postoperatively, and it has been shown that surgery within an acute time frame may increase the risk of arthrofibrosis.1 Although specific times are arbitrary, consideration should be given to the “personality of the injury.”In cases of severe injuries, significant swelling, soft tissue damage, associated capsular or multiligamentous damage, it is better to delay surgery until the acute inflammatory phase resolves. Once the inflammation subsides, preoperative treatment should include physical therapy to obtain full range of motion (-3 to 125°) and quadriceps function. In isolated or less severe injury patterns, full range of motion should be achieved prior to surgery.