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Case Reports in Orthopedics
Volume 2017, Article ID 6383526, 7 pages
Case Report

Delayed Tibial Osteomyelitis after Anterior Cruciate Ligament Reconstruction with Hamstrings Autograft and Bioabsorbable Interference Screw: A Case Report and Review of the Literature

1Broward Health Medical Center, Nova Southeastern University College of Osteopathic Medicine, Fort Lauderdale, FL 33316, USA
2Boca Care Orthopedics, Florida Atlantic University College of Medicine, Boca Raton, FL 33431, USA
3Lynn University Athletic Department, 3601 N. Military Trail, Boca Raton, FL 33431, USA

Correspondence should be addressed to James R. Ross; moc.liamg@ssormijcodohtro

Received 17 June 2017; Revised 1 September 2017; Accepted 7 September 2017; Published 15 October 2017

Academic Editor: John Nyland

Copyright © 2017 Kevin S. Weiss et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Osteomyelitis following arthroscopically assisted anterior cruciate ligament (ACL) reconstruction has rarely been reported in the literature. We report a case of a 20-year-old female who had delayed tibial osteomyelitis and a pretibial cyst with culture-positive, oxacillin sensitive Staphylococcus epidermidis 15 months after an ACL reconstruction with hamstring autograft. Soft tissue fixation within the tibial tunnel was with a poly-L-D-lactic acid (PLDLA) bioabsorbable interference screw. The patient underwent surgical treatment with curettage, debridement, hardware removal, and bone grafting of the tibial tunnel followed by a course of intravenous antibiotics. Arthroscopic evaluation demonstrated an intact ACL graft without any evidence of intra-articular infection. The patient returned to collegiate athletics without any complications. While the most common biologic complications include pretibial cysts, granuloma formation, tunnel widening, and inflammatory reactions, infection is exceedingly rare. Late infection and osteomyelitis are also rare but can occur and should be considered in the differential diagnosis.