Arthroscopic anterior cruciate ligament (ACL) reconstruction has become one of the most commonly performed procedures in orthopedic surgery and knee reconstruction. Over the last decade, the results of arthroscopic ACL reconstruction have remained outstanding in most peer-reviewed series, regardless of surgical technique. However, the published literature regarding postoperative complications after ACL reconstruction remains quite sparse.
Paulos were the first to describe the “infrapatellar contracture syndrome (IPCS),” an “exaggerated pathologic fibrous hyperplasia” of soft tissue in the anterior knee after intra-articular surgery and specifically after ACL reconstruction. IPCS can create significant arthrofibrosis, loss of knee motion, decreased patellar mobility (“patellar entrapment”), and even patella infera. The diagnosis of IPCS according to these authors was based on a “decrease in patellar mobility as compared with the opposite knee,” zero or negative passive patellar tilt, and less than 2 cm of superior/inferior patellar glide. Without appropriate identification and aggressive treatment, IPCS after ACL reconstruction results in significant functional morbidity.