Introduction: One of the complications of the anterior cruciate ligament (ACL) reconstruction is postoperative infection. It was reported that the incidence was about 1%. The symptoms often occur within several weeks after surgery. We report a case developing infection in 17 years after ACL reconstruction.
Case: A 39-year-old man received ACL reconstruction on his left knee using double-bundle hamstring autograft 17 years ago. His past medical history was the left meniscal suture three years ago. He was referred to our hospital from the private doctor because he showed signs of pain, swelling and heat of his left distal thigh with unknown etiology. We performed emergency surgery because we diagnosed his left femoral osteomyelitis and abscess around his left femur. We found no ligament tear, meniscal tear or infection in his left knee joint with arthroscopy. We washed, and performed debridement against his left thigh pus from the subcutaneous and muscular layers to femur. We found lytic bone defect around the end button in front of the femur, so we removed it, washed and injected a biopex containing an antibiotic. We successfully controlled knee infection.
Discussion: Infection after reconstruction often occurs in a knee joint within a few weeks after surgery. We speculated that the late infection of this case occurred around the end button and osteomyelitis occurred. We were able to control the infection by washing and performing debridement of the infection area and administered antibiotics. Even if a long period of 17 years after the surgery has passed, the infection can still occur. Therefore it is necessary to perform the early diagnosis and the appropriate treatment when the infection symptoms are recognized.
Conclusion: We experienced a case developing infection in 17 years after ACL reconstruction.
