A Rare Case of Osteomyelitis Following Meniscectomy with Bioabsorbable Pin Implementation: Diagnostic Challenges and Management

Eşref Selçuk, Murat Erem, Ahmet Alp Eren Kavruk, Cem Çopuroğlu, Mert Özcan, Mert Çiftdemir

Keywords: Osteomyelitis, Bioabsorbable Pin, Meniscectomy

Introduction:

Osteomyelitis is a severe and potentially debilitating bone infection. It usually presents with localized pain, swelling, and limited joint movement. In some cases, simultaneous abscess formation may complicate the clinical picture. Osteomyelitis can arise from open fractures, hematogenous spread, or post-surgical interventions. It often requires prolonged antibiotic use and surgical interventions.

Case:

A 61-year-old male patient presented to the emergency department with difficulty walking and thigh pain. The patient's medical history revealed hypertension and a meniscectomy with bioabsorbable pin implementation at another medical facility three months ago. Postoperative symptoms persisted. At another hospital, the patient received treatment based on preliminary diagnoses of deep vein thrombosis and cellulitis, including administration of low molecular weight heparin and antibiotics. Upon the patient's arrival at our emergency department, laboratory findings revealed elevated levels of CRP , sedimentation rate, and white blood cell count. An ultrasound performed in the emergency department reported a lesion compatible with a 5 cm hematoma on the medial side of the thigh. MRI results revealed a bioabsorbable pin entry site in the distal right femur, osteomyelitis in the right femur, and abscess formations in the proximal thigh muscles. Methicillin-resistant Staphylococcus aureus was detected in the patient’s bone culture, a hospital-acquired and resistant infection with Cerny Type 4-A osteomyelitis. The surgical intervention included drainage of the abscess, curettage of the medulla with flexible reamers, and placement of antibiotic cement into the medullary canal. The patient received antibiotics for 12 weeks, underwent serial debridements, and eventually recovered

Discussion:

Osteomyelitis is a very rare complication following the use of bioabsorbable pins . In the literature, very few cases related to the use of bioabsorbable pins and infection have been found. An increase in the use of bioabsorbable pins might lead to a higher frequency of hospital-acquired infections and complications of this nature.

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