# All-Arthroscopic Anterior and Posterior Arthrolysis for Extension Deficit After Anterior Cruciate Ligament Reconstruction

## TL;DR

This paper introduces a minimally invasive arthroscopic technique to treat knee stiffness after ACL surgery by releasing fibrotic tissue and restoring full extension.

## Contribution

The novel contribution is an all-arthroscopic method combining anterior and posterior arthrolysis to address extension deficits after ACL reconstruction.

## Key findings

- The technique allows controlled capsular release with reduced surgical morbidity.
- Intraoperative assessment typically shows restoration of full knee extension.
- The method is efficient and minimizes soft tissue trauma compared to open approaches.

## Abstract

Persistent knee extension deficit after anterior cruciate ligament reconstruction is a disabling complication often associated with intra-articular fibrosis within the intercondylar notch and posterior capsular adhesions. This article presents a safe, efficient, and reproducible all-arthroscopic technique for treating such deficits via combined anterior and posterior arthrolysis. The procedure includes resection of cyclops lesions and anterior fibrotic tissue, followed by posterior capsular release using posteromedial, trans-septal, and posterolateral portals. In contrast to open approaches, this technique allows controlled capsular release while limiting surgical morbidity. Intraoperative assessment typically shows restoration of full extension, with reduced operative time and limited soft tissue trauma. This minimally invasive technique provides an effective option for early management of knee stiffness following anterior cruciate ligament reconstruction and warrants further validation through prospective clinical studies.