title: Mycobacterium fortuitum infection after anterior cruciate ligament reconstruction using a polylactic acid bioabsorbable screw: Case report.
abstract: We report a case of pretibial sinus and abscess after anterior cruciate ligament reconstruction using a polylactic acid tricalcium phosphate bioabsorbable screw for tibial fixation. Mycobacterium fortuitum was identified as the pathogen after specific mycobacterial cultures were obtained from operative specimens. M. fortuitum is a known but rare cause of periprosthetic infection. Diagnosis is often delayed as routine microbiological cultures do not utilise specific culture requirements for mycobacterial growth. There have been several reports in the literature of sterile abscesses associated with bioabsorbable screws. To our knowledge, this is the first case report of a non-tuberculous mycobacterial infection associated with a bioabsorbable implant. This case illustrates that post-operative Mycobacterium infection can occur as a complication of ACL reconstruction with bioabsorbable screw fixation and should be considered in the differential diagnosis of post-operative periprosthetic infection.
authors.affiliation: Sydney Knee Specialists, Suite 211, 203-233 New South Head Road, Edgecliff, NSW 2027, Australia.
authors.forename: Horng Lii
authors.initials: HL
authors.lastname: Oh
authors.forename: Darren B
authors.initials: DB
authors.lastname: Chen
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Seeto
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Macdessi
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D000293:Adolescent; D016118:Anterior Cruciate Ligament / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D001863:Bone Screws / Q000009:adverse effects / Q000382:microbiology; D005260:Female; D006801:Humans; D019344:Lactic Acid; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D019907:Mycobacterium fortuitum / Q000302:isolation & purification*; D011091:Polyesters; D011108:Polymers; D011474:Prosthesis Design; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000295:instrumentation; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology* / Q000382:microbiology
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)