Complications accompanying anterior cruciate ligament reconstruction along with methods of management

Anterior cruciate ligament reconstruction is a widely performed surgical intervention for restoring knee stability following ligament rupture. However, it is associated with a spectrum of complications that may compromise clinical outcomes. This review categorizes these complications into four domains: diagnostic inaccuracies, graft harvesting-related issues, graft size mismatches, and osseous tunnel malpositioning. Delayed diagnosis and undetected concomitant injuries, such as medial collateral ligament damage, contribute to graft failure and increased joint instability. Graft harvesting complications, including infection, saphenous nerve injury, and patellar fractures, underscore the importance of meticulous surgical technique and infection control. Graft-tunnel mismatch can result in graft failure and suboptimal biomechanical outcomes, necessitating preoperative imaging and intraoperative adjustments. Malpositioning of osseous tunnels remains a significant challenge, often leading to impaired knee mechanics and graft rupture. This article outlines evidence-based preventive strategies and management approaches to address these complications, emphasizing the importance of individualized surgical planning to enhance patient outcomes and reduce morbidity in anterior cruciate ligament reconstruction.