Rare Nontuberculous Mycobacterium Infection Following Anterior Cruciate Ligament Reconstruction in a Healthy Young Male

Infection after anterior cruciate ligament (ACL) reconstruction is rare and is usually caused by pyogenic organisms. We report an unusual case of Mycobacterium fortuitum infection in a healthy 24-year-old male following ACL reconstruction. The patient presented with recurrent lateral thigh discharging sinuses without systemic symptoms or septic arthritis. Surgical exploration revealed sinus tracts communicating with the femoral Endobutton and biofilm formation. Management required multiple debridements, implant removal, partial graft debridement, and prolonged, modified antimicrobial therapy as it was complicated by drug intolerance. This case highlights the diagnostic and therapeutic challenges of nontuberculous Mycobacterial infections following ACL reconstruction.