Knowledge of post-operative clinical and laboratory changes in the uncomplicated course of ACL reconstruction could assist orthopaedic surgeons in making a timely diagnosis of septic arthritis. A total of 58 candidates to ACL reconstruction were enrolled in this study according to inclusion/exclusion criteria. Pre-and post-operative changes on I", 3 rd , T", 15 th, and 30 t h day were collected for skin body temperature (SBT), knee pain (KP), white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP). Post-operative joint effusion was recorded when inhibiting quadriceps contraction. The post-operative changes were compared with baseline values at each time point in the whole sample and in the subgroups of patients receiving bone-patellar-tendon-bone (BPTP) or hamstring tendon (HT) autograft. Follow-up at six month was considered adequate to rule out surgery-related septic arthritis. Mean SBT significantly increased on I", 3 r d and 7 th post-operative day and returned to values not differing from baseline on 15 t h and 30 t h day. Median KP was significantly elevated during the first month. Joint effusion was observed on 7 t h post-operative day in 52% of patients. Mean WBC count significantly increased on 1'1, T" and 15 t h day while no difference from baseline was observed on 3 rd and 30 th day. Mean ESR was significantly elevated on I" day, increased on 3 rd day and peaked on 7 th day. ESR decreased on 15 t h and 30 th day but remained significantly higher than baseline. Mean CRP significantly increased on 1st day, peaked on 3 rd day and decreased on 7 t h day, while levels on 15 th and 30 th day did not differ from baseline. The SBT, KP, WBC count, ESR and CRP changes stratified in relation to the type of autograft showed the same variation trend as in the whole sample. Close clinical surveillance may be advisable when SBT, occurrence of joint effusion and CRP levels deviate from the described reference trend two weeks after surgery.Although the natural history of ACL-insufficient knees is unclear (1-2), it is generally agreed that recurrent episodes of symptomatic instability would lead to an accrual ofjoint damage (l , 3), particularly if a meniscectomy has been performed following ACLtear (4). The indication for ACL reconstruction includes the desire of recreational or professional athletes to return promptly to the pre-injury activity level or the persistence of symptomatic instability following rehabilitation and activity level modifications (l, 3).The onset of septic arthritis, the reported rate of