The compartment syndrome is a condition characterized by a raised hydraulic pressure within a closed and non expandable anatomical space. It leads to a vascular insufficiency that becomes critical once the vascular flow cannot return the fluids back to the venous system. This causes a potential irreversible damage of the contents of the compartment, especially within the muscle tissues. Gluteal compartment syndrome (GCS) secondary to hematomas is seldom reported. Here we present a case of a 51-year-old patient with history of a non-Hodgkin lymphoma who underwent a bone marrow aspiration from the posterior iliac crest that had excessive bleeding at the puncture zone. The patient complained of increasing pain, tenderness, and buttock swelling. Intraoperative pressure validation of the gluteal compartment was performed, and a GCS was diagnosed. The patient was treated with a gluteal region fasciotomy. The patient recovered from pain and swelling and was discharged shortly after from the hospital. We believe clotting and hematologic disorders are a primary risk factor in patients who require bone marrow aspirations or biopsies. It is important to improve awareness of GCS in order to achieve early diagnosis, avoid complications, and have a better prognosis.

Double-bundle anterior cruciate ligament (ACL) reconstruction can be demanding and time consuming and requires twice as many implants, increasing both costs and possible complications. In this article, we present a new approach to double bundle ACL reconstruction: a biological fixation of the tibial side by means of a double tunnel and a U-shape passage of an anterior tibialis allograft, fixed into a double tunnel on the femoral condyle with 2 interference bioabsorbable screws. The technique is designed to combine 2 known procedures for the regular knee surgeon: the mono-tunnel technique and the medial-portal approach.

Anterior cruciate ligament (ACL) injuries are very common among athletes. If these injuries are not repaired, meniscus and cartilage damage will arise, with serious consequences in the joint. Different options for ACL reconstruction have been described, aiming for anteroposterior, lateral, and rotational stability. Using single- or double-bundle grafts has been one of the most discussed topics, aiming for better rotational stability. We performed a prospective randomized study to evaluate the outcomes of ACL reconstruction using double- or single-bundle grafts for 72 patients with acute ACL injuries. Patients were blindly randomized into 2 groups of 36 knees before surgery using a blind envelope that contained the technique to be used: double-bundle U-Dos technique (DB group) or single-bundle technique (SB group). All patients had a preoperative and postoperative evaluation and were followed with the same parameters at 2, 4, 6, 12, and 24 months. Both anteroposterior and rotational stability were evaluated using a KT-1000 arthrometer (MEDmetric) and an experimental Pivot-Shift Meter (ORMEDS) device. Functional outcomes were measured using the Tegner-Lysholm scale. The DB group had fewer ACL re-tears, fewer meniscal injuries, and better Tegner-Lysholm and International Knee Documentation Committee scores. This group also had better KT-1000 and Pivot-Shift Meter values. After 2-year follow-up, the DB group had significantly better results than the SB group. [ Orthopedics . 2023;46(1):13–18.]