Accumulation of irrigation fluid in the calf as a complication during hightibial osteotomy combined with simultaneous arthroscopic anterior cruciateligament reconstruction

Extravasation of irrigation fluid during arthroscopy is a well-known compli cation. We report a case of accumulation of fluid into the calf during open wedge high tibial osteotomy combined with simultaneous arthroscopic anteri or cruciate ligament (ACL) reconstruction. The main cause for fluid extrava sation was the drilling of the tibial tunnel, which allowed the fluid to cr oss the osteotomy gap and invade the flexor compartments. Although an eleva tion of the intracompartmental pressure was measured, there was no clinical evidence of compartment syndrome. A subcutaneous release of the flexor com partment of the leg was performed. The patient suffered no further sequelae . High tibial osteotomy combined with simultaneous arthroscopic ACL reconst ruction has to be performed carefully, and potential complications must be detected immediately to prevent compartment syndrome.