A study on the outcome of autograft soaking of vancomycin for anterior cruciate ligament reconstruction surgeries

Daivik Taranath Shetty; M U Abhishek; Gaurav Kishore Shetty; M S Shashikumar

doi:10.53730/ijhs.v6nS8.10566

Authors

Daivik Taranath Shetty Senior resident, Department of orthopaedics, shivamogga institute of medical sciences
Abhishek M U Senior resident, Department of orthopaedics , Bangalore medical college
Gaurav Kishore Shetty Senior resident, Department of orthopaedics, shivamogga institute of medical sciences
Shashikumar M S Senior resident, Department of orthopaedics, shivamogga institute of medical sciences

Keywords:

autograft, vancomycin, anterior cruciate ligament, reconstruction

Abstract

Background: In Anterior Cruciate Ligament (ACL) reconstruction surgery the rate of development of infection or septic arthritis is an uncommon but devastating condition. Presoaking of autografts into the vancomycin has also shown to be effective in reducing the rate of infection in ACL reconstruction patients. This present study thus assessed the efficacy of vancomycin presoaking autograft in decreasing the rate of infection in ACLR patients. Material and methods: This is a hospital-based prospective study conducted in the A.J. Institute of Medical Sciences, Mangalore starting from August 2017 to January 2020 for 3 years. In this study patients from the age group of 18 years to 40 years were included. The vancomycin-soaked grafts were used in these patients. After the operation, the patients were discharged after 10 days. The follow-up was done for 12 months postoperatively. The presence of infection was done and the improvement in the patient’s activity was further evaluated using two scores International Knee Documentation Committee (IKDC) score and the Lysholm knee scoring scale. The result of this study was tabulated and then evaluated using SPSS software. Result :In this study total of 100 patients were included with a mean age of 28.1 ± 7.1 years.

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References

Chaturvedi, D. B. N., Bhimwal, O. & Dhaundiyal, S. Does Presoaking of Autografts in Vancomycin Reduces the risk of Infection After ACL Reconstruction (?): A Retrospective Study. J. Med. Sci. Clin. Res. 08, (2020).

Pérez-Prieto, D. et al. Autograft soaking in vancomycin reduces the risk of infection after anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 24, 2724– 2728 (2016).

Phegan, M., Grayson, J. E. & Vertullo, C. J. No infections in 1300 anterior cruciate ligament reconstructions with vancomycin pre-soaking of hamstring grafts. Knee Surg. Sports Traumatol. Arthrosc. 24, 2729–2735 (2016).

Raines, B. T., Naclerio, E. & Sherman, S. L. Management of Anterior Cruciate Ligament Injury: What’s In and What’s Out? Indian J. Orthop. 51, 563–575 (2017).

Duchman, K. R., Lynch, T. S. & Spindler, K. P. Graft Selection in Anterior Cruciate Ligament Surgery. Clin. Sports Med. 36, 25–33 (2017).

Torres-Claramunt, R. et al. Knee joint infection after ACL reconstruction: prevalence, management and functional outcomes. Knee Surg. Sports Traumatol. Arthrosc. 21, 2844– 2849 (2013).

Wang, C., Lee, Y. H. D. & Siebold, R. Recommendations for the management of septic arthritis after ACL reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 22, 2136–2144 (2014).

Khatoon, Z., McTiernan, C. D., Suuronen, E. J., Mah, T.-F. & Alarcon, E. I. Bacterial biofilm formation on implantable devices and approaches to its treatment and prevention. Heliyon 4, e01067 (2018).

Tanner, J., Norrie, P. & Melen, K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst. Rev. (2011) doi:10.1002/14651858.CD004122.pub4.

Naendrup, J.-H. et al. Vancomycin-soaking of the graft reduces the incidence of septic arthritis following ACL reconstruction: results of a systematic review and meta-analysis. Knee Surg. Sports Traumatol. Arthrosc. 28, 1005–1013 (2020).

Baron, J. E. et al. Graft Preparation with Intraoperative Vancomycin Decreases Infection After ACL Reconstruction: A Review of 1,640 Cases. J. Bone Jt. Surg. 101, 2187–2193 (2019).

Mei, Y. et al. Clinical characteristics of 4355 patients with anterior cruciate ligament injury. Chin. Med. J. (Engl.) 126, 4487–4492 (2013).

Indelli, P. F., Dillingham, M., Fanton, G. & Schurman, D. J. Septic arthritis in postoperative anterior cruciate ligament reconstruction. Clin. Orthop. 182–188 (2002) doi:10.1097/00003086-200205000-00026.

Offerhaus, C. et al. Vancomycin pre-soaking of the graft reduces postoperative infection rate without increasing risk of graft failure and arthrofibrosis in ACL reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 27, 3014–3021 (2019).

Vertullo, C. J., Quick, M., Jones, A. & Grayson, J. E. A Surgical Technique Using Presoaked Vancomycin Hamstring Grafts to Decrease the Risk of Infection After Anterior Cruciate Ligament Reconstruction. Arthrosc. J. Arthrosc. Relat. Surg. 28, 337–342 (2012).

van Yperen, D. T., Reijman, M., van Es, E. M., Bierma-Zeinstra, S. M. A. & Meuffels, D. E. Twenty-Year Follow-up Study Comparing Operative Versus Nonoperative Treatment of Anterior Cruciate Ligament Ruptures in High-Level Athletes. Am. J. Sports Med. 46, 1129– 1136 (2018).

Schuster, P. et al. Soaking of autografts in vancomycin is highly effective in preventing postoperative septic arthritis after revision anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 28, 1154–1158 (2020).

Suryasa, I. W., Rodríguez-Gámez, M., & Koldoris, T. (2021). Health and treatment of diabetes mellitus. International Journal of Health Sciences, 5(1), i-v. https://doi.org/10.53730/ijhs.v5n1.2864

Aprianto, D. R., Parenrengi, M. A., Utomo, B., Fauzi, A. A., & Subagyo, E. A. (2022). Autograft and implant cranioplasty in pediatric patients. International Journal of Health & Medical Sciences, 5(1), 129-136. https://doi.org/10.21744/ijhms.v5n1.1852