Nathan Wanderman1, Joseph Thurn2, Mitchell Wyffels3, Jonathan N Sembrano2,3. 1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota. 2. Departments of Infectious Diseases (J.T.) and Orthopaedic Surgery (J.N.S.), Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota. 3. Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota.
Abstract
CASE: A 43-year-old man with a history of well-controlled HIV (human immunodeficiency virus) infection presented with sacroiliac joint destruction from a Mycobacterium gordonae infection. A sacroiliac joint arthrodesis was performed using a minimally invasive technique utilizing both biologic fusion (allograft bone with rhBMP-2 [recombinant human bone morphogenetic protein-2]) and fixation with titanium ingrowth rods. CONCLUSION: To our knowledge, this is the first reported case of infectious sacroiliitis from a nontubercular mycobacterium (M. gordonae) treated with a combination of joint debridement, biologic fusion with bone graft, and nonbiologic functional fusion using titanium ingrowth rods, all performed in a minimally invasive fashion. This strategy effectively alleviated pain and preserved function at 2 years of follow-up.
CASE: A 43-year-old man with a history of well-controlled HIV (human immunodeficiency virus) infection presented with sacroiliac joint destruction from a Mycobacteriumgordonae infection. A sacroiliac joint arthrodesis was performed using a minimally invasive technique utilizing both biologic fusion (allograft bone with rhBMP-2 [recombinant humanbone morphogenetic protein-2]) and fixation with titanium ingrowth rods. CONCLUSION: To our knowledge, this is the first reported case of infectious sacroiliitis from a nontubercular mycobacterium (M. gordonae) treated with a combination of joint debridement, biologic fusion with bone graft, and nonbiologic functional fusion using titanium ingrowth rods, all performed in a minimally invasive fashion. This strategy effectively alleviated pain and preserved function at 2 years of follow-up.