Abnormal Thigh Swelling after Anterior Cruciate Ligament Reconstruction with Tourniquet

Hamidreza Aslani; Seyyed Mehdi Hosseini; Emad Kouhestani; Amir Bisadi

doi:10.18502/jost.v9i3.13036

Hamidreza Aslani Professor, Department of Orthopedics, Knee and Sport Medicine Education and Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyyed Mehdi Hosseini Clinical Fellowship Candidate, Department of Orthopedics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Emad Kouhestani Resident, Department of Orthopedics, Knee and Sport Medicine Education and Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Amir Bisadi Assistant Professor, Department of Orthopedics, Knee and Sport Medicine Education and Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v9i3.13036

Keywords: Anterior Cruciate Ligament; Case Report; Anterior Cruciate Ligament Reconstruction; Edema

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction surgery is a common orthopedic procedure. Minimally invasive surgeries and arthroscopy are becoming more common, and tourniquets are utilized in these procedures to reduce bleeding and allow for improved tissue visualization.

Case Report: In this paper, we report a 32-year-old man who underwent the right knee ACL reconstruction using a tourniquet following trauma. He developed thigh swelling at the tourniquet site after surgery. Right thigh ultrasound and magnetic resonance imaging (MRI) indicated extensive interstitial edema in all compartments without collection, hematoma, or hemorrhage. The patient was treated with dexamethasone and Lasix for four days. Rehabilitation activities included exercises to improve range of motion (ROM), strength exercises, and a home workout routine. Two weeks after discharge, the swelling decreased by about 80%.

Conclusion: We believe that using a tourniquet during the reconstruction surgery may be responsible for the extensive edema in the limb. However, despite several diagnostic methods, we could not explain the reason for the edema in the limb following surgery.