Journal
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
Volume 142, Issue 6, Pages 1141-1146Publisher
SPRINGER
DOI: 10.1007/s00402-021-04004-w
Keywords
Septic arthritis; Knee infection; Antibiosis; Infection staphylococcus; Antibiotic prophylaxis; ACL reconstruction; Graft failure
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The study evaluated the effectiveness of using vancomycin (1 mg/ml) for preventing septic arthritis after ACL reconstruction. Results showed that soaking grafts in vancomycin was effective in reducing infection rates.
Purpose The aim of the present study was to evaluate if the vancomycin (1 mg/ml) is effective for the prevention of septic arthritis after ACL reconstruction. The hypothesis was that local antibiotic prophylaxis by soaking ACL grafts in vancomycin results in significantly less infections than ACL reconstruction without local antibiosis. Methods In group 1, 636 patients who were operated between 1.9.2014 and 31.8.2016 received no local antibiotic treatment with vancomycin. In group 2, 536 patients who were operated between 1.9.2016 and 31.8.2018 received local antibiotic treatment with vancomycin (1 mg/ml). In this group the graft was soaked in the vancomycin solution for 10 min prior to graft passage and fixation. Results In group 1 (ACL reconstruction without vancomycin application), a postoperative infection was detected in ten patients (infection rate: 1.6%). In group 2 (ACL reconstruction with 1 mg/ml vancomycin), no postoperative infection was detected (infection rate: 0%). The statistical analysis showed a clear significant difference between the two groups (p = 0.002). The re-rupture rate and the rate of arthrofibrosis differed not significantly between the two treatment groups (p = 0.526). Conclusion The results of the present study show that graft soaking in vancomycin (1 mg/ml) is effective for the prevention of septic arthritis after ACL reconstruction.
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