The fate of intra-articular debris following arthroscopic anterior cruciate ligament reconstruction.

Abstract

The debris generated during arthroscopic anterior cruciate ligament (ACL) reconstruction may be seen on postoperative radiographs. The purpose of this study was to evaluate the incidence, effects, and natural history of intra-articular debris following ACL reconstruction. This retrospective review included 99 ACL reconstructed knees in 96 patients. Radiographically visible debris was present in 63% of knees (bone in 59% and metal in 4%), and 37% of knees had no visible debris. Bone was most commonly seen in the posterior compartment (95%), and metal within the intercondylar notch. There were no differences in the incidence of debris between reaming techniques, single and dual incision techniques, or between graft types. Metal debris was always associated with retrograde reaming. Complete disappearance of bone debris was noted in 71% (3 to 6 months). Of the 25% of knees that showed persistent bone debris, in 79% it had decreased in size. There was no change in the appearance of metal debris (4%). No patient experienced mechanical symptoms directly related to debris. No secondary surgeries for debridement of debris or loose body removal were required. Bone debris produced during arthroscopic ACL reconstruction appears clinically benign, and is likely to disappear by 6 months. Long-term effects are unknown. Metal debris is persistent, but not problematic over the short-term.