What are the potential complications that may occur during the MCL reconstruction?

Intraoperative complications of MCL reconstruction surgery

Due to the recent advances noted within the orthopedic field, MCL reconstruction surgery can now be performed using minimally invasive techniques, which have been shown to reduce the risks associated with previous or traditional techniques as it only requires very small incisions.

Intraoperative complications of MCL reconstruction surgery include morbidity associated with:

• Iatrogenic (surgery-induced) vascular and nerve injury: Direct trauma during the surgical reconstruction of the ligaments may disrupt or compromise the previous vascular repair. Therefore, pre-operative, intra-operative, and post-operative vascular evaluation is essential with or without vascular repair.
• Anesthesia complications
• Tourniquet and wound complications: Superficial or deep wound infections may develop after ligamentous knee surgery, the incidence being 0.30-12.5% in open reconstructions.

Post-operative complications of MCL reconstruction

Numbness and decreased range of motion are the most common complications associated with MCL reconstruction. The other possible complications include:

• Knee stiffness: Stiffness in the knee can be attributed to the timing of repair, non-anatomic repair, and postoperative rehabilitation problems. If the superficial MCL is stabilized in close proximity to the joint line, it may feel as though your knee is captured.
• Residual laxity: Failure to address all the aspects of the injury, particularly the meniscus and posteromedial structures can lead to residual instability. In order to attain optimal stability, repeated examinations should be done at various stages of repair.
• Compartment syndrome
• Deep venous thrombosis
• Failure of the repair procedure

The contributing factors include the patient's age, general health and skin condition, steroid use, prior knee surgery, and prolonged tourniquet time.