Table 2.

Complications related to technical errors at the time of surgery

Complication	Clinical effect	Prevention	Detection	Remedy
Excessive release [4, 7, 13]	Medial instability	Do not release vastus lateralis unless salvage/refractory (Fig. 2)	Medial patella subluxation/dislocation, excessive medial glide, medial apprehension test, positive gravity subluxation test	Revision with lateral retinacular repair and imbrication/bracing/rehabilitation
Excessive release [2, 3]	Weakness	Do not release vastus lateralis unless salvage/refractory	Significant quadriceps weakness by examination with atrophy	Revision with lateral retinacular repair and imbrication/bracing/rehabilitation
Insufficient release [3, 5]	Symptoms unchanged	Release to level of muscle fibers proximally and include patellotibial ligament distally (Figs. 3 and 4)	Postoperative examination similar to preoperative	Ensure adequate release intraoperatively (observe muscle fibers) and extend to anterolateral portal
Failure to cauterize superolateral geniculate [3, 4, 16–18]	Painful hemarthrosis	Reduce pressure or flow to identify bleeding before closure, use cautery device, do not elevate tourniquet unless necessary	Postoperative hemarthrosis	Ice, compression, pain medications, modalities, aspiration, repeat arthroscopy with evacuation of hematoma/cauterization
Failure to avoid past point with cautery and maintain visualization [3, 10]	Burn skin/dermis	Avoid past point with cautery and maintain visualization	Skin burn	Local wound care