Patient #3 – 16 year old male with an infected ACL graft

About the Patient

This teenage boy tore his ACL playing basketball. He had ACL reconstruction surgery done at a different facility using an allograft graft. This graft became infected and despite antibiotic treatment, the graft had to be removed to resolve the infection. After he had healed from the infection and surgery, he went to a different doctor and had the surgery repeated at a different hospital. This was also done with an allograft, but the graft came from a different tissue bank. Again the repaired graft became infected and had to be removed. Cultures showed that it was a different bacteria that infected the second graft than was present the first time around.

Treatment

When this patient was seen by our office, he had instability in the knee because of the lack of an ACL. Additionally, the recurrent infections had damaged to both the menisci in the knee and they had both been removed. The infection also had damaged the surrounding bone and there was bone missing. Dr Prodromos first performed a bone graft to repair the bone damage. He then performed an ACL reconstruction using a hamstring autograft. Both of these surgeries were successful and there was no problem with infection. The patient then needed to have 2 MATs done to replace the removed menisci. This surgery was also accomplished without any problems.

Results

Two years after surgery, the patient is fully functional and pain free. However, he was strongly advised to give up sports because of the damage that was done to his knee during the two failed surgeries. These surgeries created some arthritic changes that will get worse over time. Heavy use, like playing sports, is likely to accelerate the process.