Authors’ Disclosure Statement: The authors report no actual or potential conflict of interest in relation to this article.
Dr. Spanyer is an Orthopaedic Surgeon, OrthoCincy Orthopaedics and Sports Medicine, Cincinnati, Ohio. Dr. Kwon is an Orthopaedic Surgeon, Department of Orthopaedic Surgery; and Dr. Nelson is an Infectious Disease Specialist, Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Dr. Foster is an Orthopaedic Surgeon, Avita Orthopaedics, Ontario, Ohio. Dr. Thum-DiCesare is a Neurosurgery Resident, Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, California. Dr. Burke is an Orthopaedic Surgeon, Department of Orthopaedics, Beth Israel Deaconess Hospital, Milton, Massachusetts.
Address correspondence to: Jonathon Spanyer, MD, OrthoCincy Orthopaedics and Sports Medicine, 560 South Loop Road, Edgewood, KY 45017 (tel, 859-301-2663; email, jspanyer@orthocincy.com).
Jonathon M. Spanyer, MD Scott Foster, MD Jasmine A. Thum-DiCesare, MD Young-Min M. Kwon, MD, PhD Dennis W. Burke, MDSandra B. Nelson, MD . Mycobacterium abscessus: A Rare Cause of Periprosthetic Knee Joint Infection. Am J Orthop.
September 26, 2018
TAKE-HOME POINTS:
Periprosthetic joint infections due to Mycobacterium abscess have been rarely reported, and no specific guidlines exist to inform treatment.
Medical management alone was not successful in our clinical case and cannot be recommended.
Combination medical and surgical management may provide the best opportunity for clincal cure of periprosthetic infections.
In complicated periprosthetic joint infections involving rare and intrinsically resistant organisms, a collaborative multidisciplinary approach likley represents the preferred path to clinical cure.
Successful erradiation of periprosthetic infection with M. abscessus may not preclude acceptable outcomes after revision TKA.
References
ABSTRACT
A 61-year-old woman with a periprosthetic knee joint infection caused by Mycobacterium abscessus was successfully treated with surgical débridement, multidrug antimicrobial therapy, and staged reimplantation. To the authors’ knowledge, this represents the first report of successfully treating this organism after knee arthroplasty.
M. abscessus knee infections are rare, and there are no specific guidelines to inform treatment or successful treatment regimens for periprosthetic knee infections. Medical management alone was not successful in this case and hence cannot be recommended. Using a collaborative multidisciplinary approach, including surgical débridement, staged reimplantation, and multidrug antimicrobials, successful eradication of the periprosthetic joint infection caused by M. abscessus was achieved.
