{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:48:13Z","timestamp":1780469293705,"version":"3.54.1"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,5,1]],"date-time":"2022-05-01T00:00:00Z","timestamp":1651363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T00:00:00Z","timestamp":1650153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      Clavicle osteomyelitis is a rare, but serious complication following operative repair of acromioclavicular (AC) joint separations.\n                      <jats:italic toggle=\"yes\">Cutibacterium Acnes<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">C. acnes<\/jats:italic>\n                      ) is rarely a causative pathogen in clavicle osteomyelitis and diagnosis can be challenging due to the indolent nature of this organism.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>\n                      A 45\u201350 year old female with a chronic AC joint separation underwent an open coracoclavicular reconstruction using semitendinosus allograft and FiberTape (Arthrex, Naples, FL). At the six month follow up, the patient complained of mild persistent pain. Imaging demonstrated widening of the medial suture tunnel with distal clavicle osteolysis, which was concerning for osteomyelitis. This was successfully treated with implant removal revision surgery and additional intravenous antibiotics. Cultures of the graft material were positive for\n                      <jats:italic toggle=\"yes\">C. acnes.<\/jats:italic>\n                      The patient continued to have osteolysis of the distal left clavicle for a period of time despite resolution of osteomyelitis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">C. acnes<\/jats:italic>\n                      osteomyelitis of the clavicle is difficult to diagnose because of its vague associated symptoms when implicated in infections. There are no known obvious predisposing factors for\n                      <jats:italic toggle=\"yes\">C. acnes<\/jats:italic>\n                      clavicle osteomyelitis. Literature suggests management should include aggressive irrigation and debridement, removal of any hardware, and extended intravenous antibiotic administration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">C. acnes<\/jats:italic>\n                      clavicular osteomyelitis is uncommon, thus established treatment guidelines have not yet been formed. Revision surgery to remove graft material, irrigate, and debride in addition to antibiotic treatment was successful for our patient. Additional pathologic manifestations of\n                      <jats:italic toggle=\"yes\">C. acnes<\/jats:italic>\n                      infections could include continued clavicular erosion post-clearance of infection, although further investigation is necessary.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2022.107114","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T02:27:52Z","timestamp":1650508072000},"page":"107114","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Occult clavicle osteomyelitis caused by Cutibacterium acnes (C. acnes) after coracoclavicular ligament reconstruction"],"prefix":"10.1097","volume":"94","author":[{"given":"Frederic","family":"Washburn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britni","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Golden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-115-20260304","doi-asserted-by":"crossref","first-page":"116","DOI":"10.3810\/psm.2011.02.1869","article-title":"Acromioclavicular joint injuries: anatomy, diagnosis, and treatment","volume":"39","author":"Willimon","year":"2011","journal-title":"Phys. Sportsmed"},{"key":"R2-115-20260304","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1302\/2058-5241.3.170027","article-title":"Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures","volume":"3","author":"Sirin","year":"2018","journal-title":"EFORT Open Rev"},{"key":"R3-115-20260304","doi-asserted-by":"crossref","first-page":"S313","DOI":"10.1016\/j.otsr.2015.09.012","article-title":"Complication rates and types of failure after arthroscopic acute acromioclavicular dislocation fixation. Prospective multicenter study of 116 cases","volume":"101","author":"Clavert","year":"2015","journal-title":"Orthop. Traumatol. Surg. Res"},{"key":"R4-115-20260304","first-page":"66","article-title":"Propionibacterium acnes infection complicating the operative treatment of clavicle fractures","volume":"16","author":"Von Keudell","year":"2015","journal-title":"Orthop.J.Harv.Med.Sch"},{"key":"R5-115-20260304","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.csm.2017.12.002","article-title":"Shoulder acromioclavicular and coracoclavicular ligament injuries: common problems and solutions","volume":"37","author":"Wylie","year":"2018","journal-title":"Clin. Sports Med"},{"key":"R6-115-20260304","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.ijscr.2014.10.056","article-title":"Bilateral clavicle osteomyelitis: a case report","volume":"5","author":"Saglam","year":"2014","journal-title":"Int. J. Surg. Case Rep"},{"key":"R7-115-20260304","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.cjtee.2019.03.004","article-title":"Osteomyelitis post acromioclavicular joint reconstruction","volume":"22","author":"Yeak","year":"2019","journal-title":"Chin. J. Traumatol"},{"key":"R8-115-20260304","first-page":"3","article-title":"Cutibacterium acnes (formerly proprionibacterium acnes) and shoulder surgery","volume":"78","author":"Elston","year":"2019","journal-title":"Hawaii J. Health Soc. Welf"},{"key":"R9-115-20260304","doi-asserted-by":"crossref","first-page":"40","DOI":"10.7150\/jbji.29153","article-title":"Cutibacterium (formerly Propionibacterium) acnes clavicular infection","volume":"4","author":"Zaid","year":"2019","journal-title":"J. Bone Joint Infect"},{"key":"R10-115-20260304","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1080\/17453674.2018.1489095","article-title":"Growth of Cutibacterium acnes is common on osteosynthesis material of the shoulder in patients without signs of infection","volume":"89","author":"Both","year":"2018","journal-title":"Acta Orthop"},{"key":"R11-115-20260304","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/0973-6042.167957","article-title":"Propionibacterium acnes infection after shoulder surgery","volume":"9","author":"Kadler","year":"2015","journal-title":"Int. J. Shoulder Surg"},{"key":"R12-115-20260304","doi-asserted-by":"crossref","first-page":"1920","DOI":"10.1016\/j.jse.2020.02.020","article-title":"Cutibacterium acnes: a threat to shoulder surgery or an orthopedic red herring?","volume":"29","author":"Patel","year":"2020","journal-title":"J. Shoulder Elb. Surg"},{"key":"R13-115-20260304","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus surgical CAse REport (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R14-115-20260304","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.jse.2019.12.032","article-title":"Prevention of Cutibacterium acnes infection in arthroscopic shoulder surgery: a systematic review","volume":"29","author":"Belk","year":"2020","journal-title":"J. Shoulder Elb. Surg"},{"key":"R15-115-20260304","doi-asserted-by":"crossref","first-page":"597","DOI":"10.2106\/JBJS.15.00568","article-title":"Propionibacterium in shoulder arthroplasty: what we think we know today","volume":"98","author":"Hsu","year":"2016","journal-title":"J. Bone Joint Surg. Am"},{"key":"R16-115-20260304","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1016\/j.jse.2020.11.011","article-title":"Cutibacterium acnes in shoulder surgery: a scoping review of strategies for prevention, diagnosis, and treatment","volume":"30","author":"Foster","year":"2021","journal-title":"J. Shoulder Elb. Surg"},{"key":"R17-115-20260304","doi-asserted-by":"crossref","first-page":"e1811","DOI":"10.2106\/JBJS.L.01733","article-title":"Origin of propionibacterium in surgical wounds and evidence-based approach for culturing propionibacterium from surgical sites","volume":"95","author":"Matsen","year":"2013","journal-title":"J. Bone Joint Surg. Am"},{"key":"R18-115-20260304","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1128\/CMR.00092-13","article-title":"Propionibacterium acnes: from commensal to opportunistic biofilm-associated implant pathogen","volume":"27","author":"Achermann","year":"2014","journal-title":"Clin. Microbiol. Rev"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222003601?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222003601?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.107114","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:05:37Z","timestamp":1772618737000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.107114"}},"subtitle":["A case report and review of the literature"],"short-title":[],"issued":{"date-parts":[[2022,5]]},"references-count":18,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2022.107114","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2022,5]]}}}