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ACL Surgery Complications

The anterior cruciate ligament is important for daily function because it connects the shin bone and the thigh bone and provides stability to the knee. If the ACL is torn, typically due to athletic activity, surgery often is required to prevent buckling of the knee. As with any surgery, particularly one as extensive as with the ACL, there are risks and complications associated with the procedure.

  1. The Procedure

    • Repairing the ACL requires the torn ligament to be replaced with a new ligament, which may consist of tissues from the patient's body, which are often taken from the tendon in the knee or hamstring, or can be taken from a cadaver, which is known as an autograft. Using small incisions to access the knee and ligaments, the surgeon removes the old ligament and replaces it with the new ligament, using screws or other devices to hold the ligament in place.

    Risk: Blood Clots

    • Also known as deep vein thrombosis (DVT), blood clots can occur because the leg does not move much in the weeks following surgery. DVT symptoms include swelling, warmth around the affected area and pain. A clot is serious because it can break off and reach the heart, decreasing blood flow and causing a cardiac event. To prevent this, ACL surgery patients should wear stockings to encourage circulation, take medications such as blood thinners to reduce symptoms, or regularly move the affected leg to prevent clots.

    Infections

    • Because the surgery requires several incisions to the knee, infection is possible. Bacteria and harmful viruses can enter the incision or the surgical site and cause symptoms such as redness, swelling and secretions of pus. While a patient should be given antibiotics intravenously during surgery and take antibiotic medications following surgery, infection is still a possibility. Treatment should be sought immediately if these symptoms occur.

    Stiffness

    • While the body adjusts to the knee ligament, a patient may experience stiffness in the knee and leg that affects the patient's range of motion. Patients should undergo regular physical therapy immediately after surgery to prevent stiffness from becoming permanent. There is always the chance, however, that stiffness will occur.

    Graft Impingement

    • If a graft is not properly placed, graft impingement may occur, which results from the new ligament being attached to the bone incorrectly and the graft becoming trapped between the ends of the femur. As a result, the knee and leg may have trouble bending or moving properly. While this often can be treated with physical therapy, surgery is sometimes required to repair this incidence.

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