Stand-Alone Tibial Interference Screw Fixation and Tibial Interference Screw Plus Tibial Staple Fixation Produce Comparable Outcomes After Primary Anterior Cruciate Ligament Reconstruction Using Hamstring Autografts.

Purpose: To investigate the impact of adding a metal staple alongside the interference screw in tibial side graft fixation during anterior cruciate ligament reconstruction (ACLR). Methods: All patients treated with autograft hamstring ACLR at our institution between January 2017 and December 2021 with a minimum 1-year follow-up were reviewed retrospectively. Patients treated with a stand-alone interference screw for tibial side fixation were compared with those treated with a combination of interference screw and staple. The primary outcome was failure of the reconstructed graft. Secondary outcomes were operative time, complication rate, and reoperation rate. Results: A total of 497 patients met the study's inclusion and exclusion criteria. A combination of staple and interference screw was used in 167 patients (33.6%), whereas a standalone interference screw was used in 330 patients. There was no significant difference between the 2 groups in terms of operative time, complication rate, or failure rate. The mean follow-up was 23.25 (±13.29) months. Conclusions: Our results demonstrate that augmenting the interference screw with a staple for tibial-side fixation in ACLR does not have a significant impact on operative time, reoperation rate, complications, or failure rates. Level of Evidence: Level III, retrospective cohort study.

Acute Atraumatic Compartment Syndrome of the Thigh Due to Acquired Coagulopathy Disorder: A Case Report in Known Healthy Patient.

INTRODUCTION: We present a case of spontaneous compartment syndrome due to a very rare cause which is acquired hemophilia. CASE PRESENTATION: A 34-year-old patient presented with the right thigh swelling and features of acute compartment syndrome without history of trauma. He had no history of bleeding disorder. There were no features of infection. As his initial blood tests were within normal 16 g/dl, and his compartment syndrome worsened, he had decompression of the thigh. During the post-operative period, the patient developed persistent bleeding from the decompressed wounds and a fall in hemoglobin which led to further investigation when the blood profile showed a deficiency of factor VIII and antibodies to factor VIII, diagnosis of acquired hemophilia was made and appropriate treatment given. CONCLUSION: If atraumatic compartment syndrome diagnosed, possibility of acquired factor VIII deficiency should be raised by isolated prolonged activated partial thromboplastin time and diagnosis confirmed by measuring factor VIII activity level and detecting any factor's VIII antibodies in blood, such as in this case, the factor VIII level was 5.5 (very low) and against factor VIII antibodies level was 60.8 (high). Here, hematologist should be involved in management.