Double ACL Reconstruction Failure In A Young Soccer Player In Treatment With Retinoids

Isotretinoin is a vitamin A derivative commonly used for the treatment of severe acne. Although being effective, long-term or excessive use of isotretinoin has some toxic or side effects on the musculoskeletal system. The most frequent effects are arthralgia, myalgia with hyperostosis, reduced bone mineralization and calcifications in ligaments and tendons, tendinopathies and periosteal proliferations [1]. Excess of vitamin A intake has been shown to result in bone reabsorption via increasing the number and size of osteoclasts and decreasing osteoid surface. Retinoid- induced side effects on the musculoskeletal system can occur during both shortand long-term administration [2]. To date literature on retinoids effects on tendons is scarce [3] and to the best of authors’ knowledge studies on soft tissues integration in patients treated with vitamin A derivates were never conducted. We present the case of a double anterior cruciate ligament (ACL) reconstruction failure in a young amateur soccer player patient in treatment for severe cystic acne with isotretinoin.