Massive Proximal Extravasation as a Complication during Arthroscopic Anterior Cruciate Ligament Reconstruction

up into the pelvis during arthroscopic anterior cruciate ligament (ACL) reconstruction. Case ReportA 35-year-old patient, a former amateur football player, was referred to us due to episodes of incapacitating instability of the right-knee, both at work and leisure.Ten years previously, he had suffered a femoral shaft fracture that was treated by intramedullary nailing, followed by removal of the nail 2 years later.Clinical examination and magnetic resonance imaging confirmed an old rupture of the ACL and a tear in the posterior horn of the medial meniscus.We suggested an ACL reconstruction with the patellar bonetendon-bone graft.The operation was carried out under general anesthesia.The thigh was held in a clamp, with a pneumatic tourniquet (pressure, 250 mmHg) at the top of the leg.The arthroscopy pump used was the FMS DUO+ model (Depuy MITEK Inc., Raynham, MA, USA) which controls flow and pressure independently.The irrigation fluid used was a Lactated Ringer's isotonic solution with maximum pressure set to 100 mmHg.Exploration of the joint confirmed the ACL rupture as well the meniscal tear.The meniscus was minimally resected