In addition to standard risks associated with all orthopedic surgical procedures, posterior cruciate ligament (PCL) reconstruction poses some relatively unique potential complications. These complications arise from a combination of several factors: the relative infrequency of PCL injuries, the lack of knowledge and experience in treating them, the proximity of neurovascular structures to the PCL, and the technically demanding nature of reconstructive procedures. This article discusses the anatomy, pathogenesis, and prevention of intraoperative and postoperative complications of PCL surgery including neurovascular injury, osteonecrosis, fracture, motion loss, and persistent laxity.

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