Anterior cruciate ligament fixation devices: Expected imaging appearance and common complications

Highlights: • Surgeon preference and patient factors dictate the anterior cruciate ligament graft fixation device utilized. • Whether metal, bioabsorbable, or plastic, all implants have limitations and the propensity to cause complications. • Knowledge of a fixation devices' expected and unexpected imaging appearance improves imaging interpretation. - Abstract: Anterior cruciate ligament reconstruction is a commonly performed orthopaedic procedure which has increased in frequency over the past decade. There are a variety of fixation devices used to secure grafts within the femoral and tibial tunnels during the reconstruction procedure. An understanding of the expected appearance of the varied hardware utilized for reconstruction graft fixation, and their potential complications is important in the review of post-operative imaging. We describe the most common anterior cruciate ligament reconstruction fixation devices and illustrate their more frequently documented abnormalities.