Fracture of the femoral tunnel after an anterior cruciate ligament reconstruction

A randomized controlled trial comparing bone mineral density changes of three different ACL reconstruction techniques

“…Indeed, postoperative fracture is a serious, albeit, rare complication after ACL reconstruction. There were case reports of femoral condyle fractures [9,17,18] and proximal tibial fractures [19][20][21] after ACL reconstruction. All these injuries occurred through low energy trauma and most were sustained within the first several months after reconstruction.…”

“…It is known that soft tissue-to-bone healing occurs slower than bone-tobone healing [2,7] and bone-to-bone healing occurs in BPTB while tendon-to-bone healing happens in HT-SB and HT-DB. ACL reconstruction with BPTB, HT-SB and HT-DB grafts might induce different adaptive bone changes and hence different degrees of BMD loss due to the different extent of trauma induced, different healing responses, as well as different numbers, locations and angles of tunnels which act as stress risers and has a shielding effect on loading [8,9].…”

Proximal Tibia Fracture after Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft: A Case Report

“…Fractures of the tibial tubercle, patella, tibial tunnel, tunnel widening, femoral tunnel, and tibial tendon avulsion have all been reported [4][5][6][7][8][9][10][11][13][14][15]. Four-strand gracilis-semitendinosus autograft has also been shown to result in excellent outcomes [1][2][3].…”

Low velocity bicondylar tibial fracture following ACL reconstruction

“…Salem et al (supra-condyler, lateral femoral condyle, patellar and lateral tibial plateau) remain a potential risk. 2,3,5,11 With evidence suggesting a quicker return to sports following a bone-tendon-bone graft, 8,9 the creation of a stress raiser in the affected knee is inevitable, this pushed some surgeons to recommend a contra-lateral side harvest in professional athletes. 7 In conclusion, unexpected complex fractures might be encountered in patients post ACL reconstruction due to the vulnerable bony structure following the procedure with the creation of stress raisers.…”