What are the risks of surgery for anterior cruciate ligament insufficiency?
Graft harvest difficulties can be problematic as the surgeon is becoming comfortable with the anatomy of the pes anserinus and the hamstring tendons. It is mandatory that the surgeon receive training on this harvest technique and practice on a cadaver specimen. Some of the problems harvesting the tendons include the failure to identify the semitendinosus and gracilis distally as they coalesce; in this case more proximal identification is helpful. Another problem stems from not releasing the attachments of the tendons to the gastrocnemius resulting in premature amputation of the tendon at this attachment. Another error could stem from not passing the tendon stripper parallel to the direction of the tendon resulting in premature amputation of the tendon. Finally it is helpful if the tendon stripper is not too sharp. Tunnel malposition typically with the femoral or tibial tunnel too anterior. This malposition can result in graft impingement resulting in failure of loss of extension. Malpo
