Tibial Blowout”- A Complication of Arthroscopic Anterior Cruciate Ligament Reconstruction

The reconstruction of anterior cruciate ligament (ACL) has become the standard of care for a torn ACL in active, young athletes. Various technical complications during the surgery are documented. Of the complications pertaining to the bony tunnel preparation, the posterior femoral blow out is common. In this report we describe a complication that can occur while preparing the tibial tunnel – “tibial blow out”. This is a complication of anterior placement of the tibial tunnel and this has not been reported in the literature. We describe the identification, the possible mechanism, prevention and management of such an intraoperative complication.