Arthroscopic debridement and antibiotic-loaded cement for treatment of chronic infected tibial tunnel post-ACL reconstruction: A case report

Introduction and importance: Chronic extra-articular infections of the tibial tunnel are rare, and there are only a few cases reported in the literature, so the diagnosis and management of these infections are still unclear. Case presentation: We report a 36-year-old patient with chronic infection of the tibial tunnel after ACL reconstruction surgery. The patient was treated with arthroscopic debridement of the tibial tunnel and antibiotic cement filling. Seven months postoperative, there were no signs of infection at the surgical site and the knee joint. The patient has no pain, no joint instability, no limitation of range of motion, and no limitation in daily activities. Clinical discussion: The definitive diagnosis of chronic infection of the tibial tunnel should be carefully based on clinical signs, blood tests, and imaging to rule out combined intra-articular infections. The arthroscopic technique can be a favorable method to control and debride the inflammatory tissue of the tibial tunnel, limiting the recurrence rate postoperatively. Conclusion: Arthroscopic debridement and antibiotic-loaded cement can be considered an alternative to traditional surgical methods in the treatment of chronic infection of the tibial bone tunnel after ACL reconstruction. Level of evidence: A case report.