Effusions after anterior cruciate ligament reconstruction using the ligament augmentation device

Persistent effusions occurred in 4.3% (seven patients) of 164 patients who underwent anterior cruciate ligament (ACL) reconstruction using an autograft augmented with the ligament augmentation device (LAD) between 1986 and 1989. No bacteria were cultured from the joint fluid. The radiograph in each case showed a tibial drill hole located anteriorly or anterolaterally. Arthroscopy confirmed an abraded LAD in six cases and breakage of the LAD in one case and impingement of the graft on the femoral condyle during extension. Under polarized light microscopy, the histology of the synovia showed foreign body giant cells in one case and particles among the proliferative cells in four cases. The effusions subsided in two cases after notchplasty and in five cases after removal of the LAD. Impingement of the graft on the femoral condyle due to incorrect positioning of the tibial drill hole presumably produced particles that induced synovitis and effusions.