{
  "abstract": "This report describes the case of a woman in her 40s who developed debilitating knee pain and instability 1 year after undergoing an anterior cruciate ligament reconstruction. MRI revealed a complex pathology, including marked widening of both the femoral and tibial bone tunnels, significant perigraft cyst formation, a complete posterior root tear of the medial meniscus with extrusion and a partial tear of the lateral meniscal root. This indicated a functional failure of the primary reconstruction, leading to secondary intra-articular damage. A staged surgical approach was planned with an open excision of the proximal tibial tunnel cyst with meticulous curettage of the tunnel walls, combined with an arthroscopic all-inside repair of the medial meniscus. Substantial bone loss was addressed with autologous iliac crest bone graft. The patient experienced an uneventful recovery with significant symptomatic improvement, evidence-based approach to managing complex postoperative anterior cruciate ligament reconstruction complications.",
  "authors": [
    {
      "affiliations": [
        "Orthopaedics, St John’s National Academy of Health Sciences, Bengaluru, Karnataka, India"
      ],
      "name": "Atul John"
    },
    {
      "affiliations": [
        "Orthopaedics, Christian Medical College and Hospital Vellore, Vellore, Tamilnadu, India"
      ],
      "name": "Akhil John"
    },
    {
      "affiliations": [
        "Orthopaedics, St John’s National Academy of Health Sciences, Bengaluru, Karnataka, India"
      ],
      "name": "Pothuri Rishi Ram"
    },
    {
      "affiliations": [
        "St John’s Medical College Hospital, Bengaluru, Karnataka, India"
      ],
      "name": "Joe Joseph Cherian"
    }
  ],
  "title": "Two-stage management of a large tibial tunnel cyst and secondary meniscal root tear after anterior cruciate ligament reconstruction",
  "uid": "0a637546-cff7-51ae-9cec-413f9645acf5"
}