All-Arthroscopic Anterior and Posterior Arthrolysis for Extension Deficit After Anterior Cruciate Ligament Reconstruction.

Abstract

Persistent knee extension deficit after anterior cruciate ligament reconstruction is a disabling complication often associated with intra-articular fibrosis within the intercondylar notch and posterior capsular adhesions. This article presents a safe, efficient, and reproducible all-arthroscopic technique for treating such deficits via combined anterior and posterior arthrolysis. The procedure includes resection of cyclops lesions and anterior fibrotic tissue, followed by posterior capsular release using posteromedial, trans-septal, and posterolateral portals. In contrast to open approaches, this technique allows controlled capsular release while limiting surgical morbidity. Intraoperative assessment typically shows restoration of full extension, with reduced operative time and limited soft tissue trauma. This minimally invasive technique provides an effective option for early management of knee stiffness following anterior cruciate ligament reconstruction and warrants further validation through prospective clinical studies.