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Tytuł pozycji:

Soaking of the graft in vancomycin dramatically reduces the incidence of postoperative septic arthritis after anterior cruciate ligament reconstruction.

Tytuł:
Soaking of the graft in vancomycin dramatically reduces the incidence of postoperative septic arthritis after anterior cruciate ligament reconstruction.
Autorzy:
Schuster P; Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10, 71706, Markgroeningen, Germany. philipp_.; Clinic Nuremberg, Department of Orthopedics and Traumatology, Paracelsus Medical Private University, Nuremberg, Germany. philipp_.
Schlumberger M; Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10, 71706, Markgroeningen, Germany.; Department of Trauma Surgery, University Hospital Innsbruck, Innsbruck, Austria.
Mayer P; Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10, 71706, Markgroeningen, Germany.
Eichinger M; Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10, 71706, Markgroeningen, Germany.
Geßlein M; Clinic Nuremberg, Department of Orthopedics and Traumatology, Paracelsus Medical Private University, Nuremberg, Germany.
Reddemann F; Clinic Nuremberg, Department of Orthopedics and Traumatology, Paracelsus Medical Private University, Nuremberg, Germany.
Richter J; Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10, 71706, Markgroeningen, Germany.
Źródło:
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2020 Aug; Vol. 28 (8), pp. 2587-2591. Date of Electronic Publication: 2020 Feb 07.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: [Heidelberg, Germany] : Springer International, c1993-
MeSH Terms:
Autografts*
Anterior Cruciate Ligament Injuries/*surgery
Anterior Cruciate Ligament Reconstruction/*methods
Anti-Bacterial Agents/*administration & dosage
Arthritis, Infectious/*prevention & control
Vancomycin/*administration & dosage
Adult ; Anterior Cruciate Ligament Reconstruction/adverse effects ; Arthritis, Infectious/epidemiology ; Arthritis, Infectious/etiology ; Female ; Hamstring Tendons/transplantation ; Humans ; Incidence ; Male ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Quadriceps Muscle/surgery ; Retrospective Studies ; Tendons/transplantation ; Transplantation, Autologous
Contributed Indexing:
Keywords: ACL; Anterior cruciate ligament; Antibiotic; Complication; Infection; Local; Presoaking; Septic arthritis; Vancomycin
Substance Nomenclature:
0 (Anti-Bacterial Agents)
6Q205EH1VU (Vancomycin)
Entry Date(s):
Date Created: 20200208 Date Completed: 20201223 Latest Revision: 20201223
Update Code:
20240105
DOI:
10.1007/s00167-020-05882-0
PMID:
32030505
Czasopismo naukowe
Purpose: To determine and compare the incidence of postoperative septic arthritis following anterior cruciate ligament reconstruction (ACLR) with and without soaking of the graft in vancomycin solution prior to implantation in a large single-centre case series.
Methods: From 2004 to 2019, a total of 10,516 primary ACLR were performed and reviewed with regard to the occurrence of postoperative septic arthritis. From February 2017 onwards, all grafts were wrapped in a vancomycin-soaked (5 mg/ml) gauze swab between harvest and implantation (2294 patients, treatment group (2), prospectively followed). These were compared to 8222 patients before that date (control group (1), retrospectively evaluated). The technique of ACLR did not significantly change during the years of the study. There was no difference between the groups with regard to graft choice: Hamstring tendons were used in 99% and quadriceps tendons were used in 1% in both groups, respectively (n.s.). Routine follow-up examination was performed at 6 weeks (follow-up rate 97.1%) postoperatively. Patients with no treatment for septic arthritis at that time were classified as non-infected.
Results: There were 35 cases of postoperative septic arthritis in group 1 (incidence: 0.4%), and none in group 2 (incidence 0.0%), respectively. The difference was significant (p < 0.001).
Conclusions: Soaking of the graft in vancomycin solution prior to implantation dramatically reduces the incidence of postoperative septic arthritis in primary ACLR and should, therefore, be used in prevention of this major complication.
Level of Evidence: III.

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