Effect of Vancomycin Soaking of Hamstring Autograft on Postoperative Infection Rates in Cases of Primary ACL Reconstruction

Document Type : Original Article

Authors

Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt.

Abstract

Background: Although intravenous antibiotic prophylaxis is used, the incidence of septic arthritis after ACL reconstruction is relatively rare but devastating, ranging from 0.14% to 2.6%. Serious adverse effects on clinical outcomes, such as graft failure, arthrofibrosis, degenerative arthropathy, and even osteomyelitis, can result from postoperative infection. The purpose of the study was to investigate whether pre-soaked hamstring graft with a solution of vancomycin provides an effective way to reduce the risk of post-operative infection. We hypothesized that soaking the graft in vancomycin solution prior to implantation significantly reduces the incidence of postoperative septic arthritis

Methods: 210 patients between the ages of 19 and 46 participated in this study. In our study, the preferred graft was hamstring autograft, and all patients had isolated ACL injuries. The patients in the study were randomly divided into 2 groups (group 1: control group) and (group 2: treatment group). Saline solution was used in group 1, and vancomycin solution was used in group 2. Both groups were prospectively followed.

Results: Two cases of postoperative septic arthritis were observed in group 1 (1.8%), while group 2 had no infections at all (0%). P < 0.05 indicated that the difference was significant.

Conclusion: Prophylactic vancomycin soaking of hamstring autograft is effective to reduce the infection rate in our study and should be a standard procedure to prevent this serious complication.

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Zagazig University Medical Journal
Volume 31, Issue 3
March 2025
Pages 1145-1150

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