Ifearulundu I, Gamsarian V, Berlinberg EJ, Obioha OA, Mirle V, Forsythe B. Management of ACL Reconstruction Complicated by MRSA Osteomyelitis Requiring a Gastrocnemius Perforator Flap: A Case Report.
JBJS Case Connect 2023;
13:01709767-202309000-00035. [PMID:
37556578 DOI:
10.2106/jbjs.cc.23.00114]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
CASE
A 21-year-old woman presented with sepsis from methicillin-resistant Staphylococcus aureus, patellar osteomyelitis, and 6 × 4 × 2-cm proximal anteromedial soft-tissue defect 1 week after bone-tendon-bone autograft anterior cruciate ligament reconstruction (ACL-R). She underwent multiple irrigation and debridement (I&Ds), hardware removal, bone grafting with antibiotic-loaded tricalcium phosphate beads, and medial gastrocnemius perforator flap with plastic surgery. At 18 months after her initial ACL-R, single-stage revision ACL-R with quadriceps autograft was performed.
CONCLUSION
When acute ACL-R infection does not respond to initial I&D and Intravenous (IV) antibiotics, retained hardware and graft tissue must be removed expeditiously to prevent sepsis, osteomyelitis, and soft-tissue defects.
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