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Updated: Jul 13, 2026
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Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Rejection reaction to stabilizing bolts after ACL reconstruction: a case report
Andreas A Lamprakis1, Athanasios P Fortis, Anastasios Dimas
12nd Orthopaedic Department, General Panarcadic Hospital of Tripolis, Tripolis, Greece. Lamprakis, andreaslamprakis@hotmail.com
Summary
An adverse reaction to stabilizing bolts after anterior cruciate ligament (ACL) reconstruction caused persistent swelling and pain. Surgical removal of the bolts resolved the patient's symptoms, indicating a rare complication.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
- Stabilizing hardware, such as bolts, are used to secure grafts during ACL reconstruction.
Observation:
- A 21-year-old patient developed pretibial swelling and serous discharge six months post-ACL reconstruction with the Mark II system.
- Persistent symptoms, including swelling and tenderness, were noted one year post-operation, with radiographic evidence of periosteal reaction and tunnel widening around the femoral bolt.
Findings:
- Surgical exploration revealed fluid accumulation at the femoral site and a tibial cyst.
- Cultures from cyst effluent and surgical specimens were negative for microorganisms.
- Removal of both femoral and tibial bolts led to symptom resolution.
Implications:
- This case highlights a rare adverse reaction to orthopedic implant materials following ACL reconstruction.
- Early recognition and surgical intervention, including hardware removal, can effectively manage such complications.
- Further research into implant material biocompatibility may be warranted to minimize risks.