Abstract
Non-tuberculous Mycobacterium (NTM) infections following knee surgery are rarely reported in the literature. One month after arthroscopic lysis of adhesions from anterior cruciate ligament (ACL) reconstruction, a 67-year-old male patient presented with symptoms suggesting septic arthritis. Empiric antibiotics were initiated. Intraoperative cultures were positive for Mycobacterium abscessus. Organism-specific antimicrobial therapy with azithromycin, amikacin, and imipenem were started. Four months later the patient was switched to oral outpatient treatment with azithromycin, clofazimine and bedaquiline. Mycobacterium infections following ACL reconstruction are exceedingly rare in the United States. Successful management of Mycobacterium abscessus infection is exceptionally challenging for both orthopedists and infection disease specialists.
Highlights
Postoperative anterior cruciate ligament (ACL) reconstruction infections are rare, with postoperative infection rates ranging from 0.14-2.6% [1]
Graft choice may be associated to the risk of infection with a reported increased risk for hamstring tendon (HT) compared to bone-patellar tendon-bone (BPTB)
The patient displayed range of motion of 5-110 degrees at their follow up visit two months after cefoxitin was discontinued he was switched to a complete oral antibiotic that included azithromycin, clofazimine and bed aquiline
Summary
Postoperative anterior cruciate ligament (ACL) reconstruction infections are rare, with postoperative infection rates ranging from 0.14-2.6% [1]. Infections following knee surgery are rarely reported in the literature [6, 7]. The patient underwent ACL reconstruction with an all-soft tissue quadriceps tendon (QT) autograft and partial medial meniscectomy one month after initial injury.
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