Acute compartment syndrome of the lower limb after revision anterior cruciate ligament reconstruction: a case report

Acute compartment syndrome (ACS) is one of the most serious orthopedic diseases causing complications and requiring emergency surgery. Most cases of ACS are associated with fractures and crush injuries. However, surgical procedures can also cause ACS. We herein describe a 41-year-old man who underwent arthroscopic surgery for revision anterior cruciate ligament reconstruction with the semitendinosus tendon. Two days after the operation, the patient developed ACS of the left lower leg. This patient had undergone anterior cruciate ligament(ACL) reconstruction previously, and we assumed that the cause of the ACS was damage to the small blood vessels from the collateral circulation during hamstring tendon harvesting. Fasciotomy was performed under general anesthesia, and his postoperative course was uneventful. ACS after revision anterior cruciate ligament reconstruction is rare. We should keep in mind that patients who have undergone previous surgery may develop ACS due to damage to the collateral circulation. To avoid ACS, harvesting tendon from the healthy side can avoid damage to the collateral circulation.