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Preparation, Procedures and Evaluation of Platelet-Rich Plasma Injection in the Treatment of Knee Osteoarthritis
Published on: January 4, 2019
Ischial Tuberosity Osteomyelitis: A Rare Complication Following Platelet-Rich Plasma Injection: A Case Report
Elad Epshtein1, Yiftach Bar, Moshe Dahan
1Department of Orthopaedic Surgery, Shamir Medical Center (Assaf Harofeh Hospital), Zerifin, Israel.
Case:
A 48-year-old man developed severe left buttock pain and elevated C-reactive protein following a third platelet-rich plasma (PRP) injection for proximal hamstring tendinopathy. Magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) demonstrated ischial bone marrow edema and cortical erosion with intense uptake. Two CT-guided aspirations were sterile. A closed endoscopic bone biopsy revealed Pseudomonas aeruginosa. Treatment with 5 weeks of intravenous ceftazidime followed by 6 weeks of oral antibiotics normalized inflammatory markers and resulted in near-complete radiologic resolution at 5 months, without the need for surgical debridement.
Conclusion:
This first reported case of PRP-associated ischial osteomyelitis highlights the role of minimally invasive pelvic bone biopsy and the importance of postinjection vigilance.
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