Literature DB >> 25416672

Autograft soaking in vancomycin reduces the risk of infection after anterior cruciate ligament reconstruction.

Daniel Pérez-Prieto1, Raúl Torres-Claramunt2, Pablo E Gelber3,4, Tamer M A Shehata5, Xavier Pelfort2,3, Joan Carles Monllau2,3.   

Abstract

PURPOSE: To determine whether the bathing of an anterior cruciate ligament (ACL) autograft in vancomycin reduces the rate of infection following an ACL reconstruction.
METHODS: Retrospective analysis of all ACL reconstructions over an 8-year period in two University Hospitals. In the initial 4-year period, all patients were operated on under classical antibiotic intravenous prophylaxis (group 1). Over the last 4-year period, this prophylaxis was supplemented with presoaking of the autograft (group 2). Presoaking was performed with sterile gauze previously saturated with a vancomycin solution (5 mg/ml).
RESULTS: There were 810 and 734 patients in group 1 and 2, respectively. Fifteen cases of knee joint infections were identified in the series (0.97 %). All of these infections occurred in group 1, representing a rate of infection of 1.85 % in comparison with 0 % in group 2 (p < 0.001).
CONCLUSIONS: Autograft presoaking with vancomycin in combination with classical intravenous antibiotic prophylaxis reduced the rate of knee joint infection following an ACLR in comparison with antibiotic prophylaxis alone. This technique could be of relevance in daily clinical practice to prevent infection after ACLR. LEVEL OF EVIDENCE: Case control study, retrospective comparative study, Level III.

Entities:  

Keywords:  Anterior cruciate ligament; Antibiotic prophylaxis; Biofilm; Knee infection; Vancomycin

Mesh:

Substances:

Year:  2014        PMID: 25416672     DOI: 10.1007/s00167-014-3438-y

Source DB:  PubMed          Journal:  Knee Surg Sports Traumatol Arthrosc        ISSN: 0942-2056            Impact factor:   4.342


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8.  The first results from the Danish ACL reconstruction registry: epidemiologic and 2 year follow-up results from 5,818 knee ligament reconstructions.

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2.  Capsular fixation limits graft extrusion in lateral meniscal allograft transplantation.

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4.  The vancomycin soaking technique: no differences in autograft re-rupture rate. A comparative study.

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5.  Contamination occurs during ACL graft harvesting and manipulation, but it can be easily eradicated.

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Review 9.  Managing septic arthritis after knee ligament reconstruction.

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