Table 5.

Postoperative complications

Postoperative course	Clinical effect	Prevention	Detection	Remedy
Infection [17, 29]	Pain, swelling, stiffness that could necessitate removal of the graft	In addition to the usual, with knee arthroscopy, be mindful of the foot going on and off the table; use waterproof drapes to prevent convection of contaminants; use trusted donor sources when allograft is used	Knee aspiration and cultures	Aggressive treatment with lavage, débridement, and intravenous antibiotic therapy; do not remove the graft and fixation on the basis of cell count (use cultures for that)
Stiffness [22]	Lack of full ROM in either flexion or extension (or both)	Proper placement of tibial and femoral tunnels; tensioning of the graft at or near terminal extension to prevent over-constraining the knee	Identified at the postoperative appointment by lack of terminal extension (within 2 weeks, typically) or flexion (typically by 6 weeks)	Aggressive postoperative rehabilitation; drop-out casting or arthroscopic lysis of adhesions for refractory cases; manipulation under anesthesia may help restore lost flexion
Patella fracture	Pain, articular cartilage injury, further disability that may require surgery	Use of allograft or hamstring autograft for ACL reconstruction; limiting postoperative contact or collision sports for an extended time; proper harvest technique	Typically as a result of impact on a bent knee; radiographs reveal the diagnosis	Protected weightbearing; surgery if the fracture is displaced