Pseudoaneurysm following hamstring tendon harvest in arthroscopic anterior cruciate ligament reconstruction: a case repo
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CASE REPORT
Open Access
Pseudoaneurysm following hamstring tendon harvest in arthroscopic anterior cruciate ligament reconstruction: a case report Chung-Wei Ho1,2, Shih-Han Lee1,2, Shen-Han Wu1,2, Chun-Yu Lin3,4, Chian-Her Lee1,2 and Jia-Lin Wu1,2*
Abstract Background: Vascular injury is a very rare complication following arthroscopic knee surgery. This is the first report of pseudoaneurysm at the saphenous branch of the descending genicular artery complicating semitendinosus tendon harvest in arthroscopic anterior cruciate ligament reconstruction. Case presentation: A 19-year-old male had developed large ecchymosis, focal swelling and tenderness around his posteromedial knee after an arthroscopic anterior cruciate ligament reconstruction. Compartment syndrome of the lower leg and deep vein thrombosis were ruled out. A pseudoaneurysm formation was confirmed through an angiography and coil embolization was performed. At one year follow up, the patient reported improved functional outcome with good stability of the knee. However, mild paresthesia over the posteromedial calf was noted due to the compression injury of the saphenous nerve by the hematoma. Conclusions: The pseudoaneurysm was presumed to result from accidental vascular injury while dissecting the accessory bands of the semitendinosus and was successfully treated by coil embolization. Care must be taken to section the expansions of the hamstring tendon, especially when the patient presents with underlying coagulopathy or vascular disease. Keywords: ACL reconstruction, Case report, Complication, Hamstring tendon harvest, Pseudoaneurysm
Background Isolated anterior cruciate ligament (ACL) tears are one of the most common orthopedic injuries, with an annual incidence of 68.6 per 100,000 person-years [1]. Surgery is recommended for young active patients who have a high predicted risk of recurrent instability and for individuals of all ages with demonstrated recurrent instability [2]. * Correspondence: [email protected] 1 Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan 2 Department of Orthopedics, Taipei Medical University Hospital, Taipei, Taiwan Full list of author information is available at the end of the article
Arthroscopic reconstruction of the ACL alone accounts for 75,000 cases per year in the United States [3]. Vascular injuries following this surgery are especially rare and account for of < 1% of all presented complications [4]. In this paper, we report on the first case of pseudoaneurysm occurring at the saphenous branch of descending genicular artery after arthroscopic ACL reconstruction by using the semitendinosus autograft and single-tunnel technique.
Case presentation A 19-year old male had a twisting injury to his left knee with a popping sensation when landing during a basketball game. The patient was otherwise healthy, but his history
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which pe
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