Delayed compartment syndrome of leg and foot due to rupture of popliteal artery pseudoaneurysm following posterior cruciate ligament reconstruction

Arthroscopic posterior cruciate ligament (PCL) reconstruction carries some risk of complications, including injury to the neurovascular structures at the popliteal region. We describe a delayed presentation of the right leg and foot compartment syndrome following rupture of popliteal artery pseudoaneurysm, which presented 9 days after an arthroscopic transtibial PCL reconstructive surgery. Fasciotomy, surgical exploration, repair of an injured popliteal vein and revascularisation of the popliteal artery with autogenous great saphenous vein interposition graft were performed. Owing to the close proximity of vessels to the tibial tunnel, special care should be taken in patients who undergo arthroscopic PCL reconstruction, especially if there is extensive scarring of the posterior capsule following previous injury. Emergency fasciotomy should not be delayed and is justified when the diagnosis of compartment syndrome is clinically made.