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

Pérez-Prieto, Daniel; Torres-Claramunt, Raúl; Gelber, Pablo Eduardo; Shehata, Tamer M. A.; Pelfort, Xavier; Monllau, Joan Carles

doi:10.1007/s00167-014-3438-y

Cited by 101 publications

(112 citation statements)

References 26 publications

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“…1 The top five journals which published the most studies and reports related to anterior cruciate ligament reconstruction. complications include OA after ACL reconstruction, 26 meniscal tears at the moment of trauma or during surgery and together with OA, 27 septic arthritis following ACL reconstruction, 28 and nerve injuries. 29 The knee is also one of the most common sites of injury in skeletally immature athletes.…”

Section: Discussionmentioning

confidence: 99%

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Yücens

Aydemir

2018

J Knee Surg

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Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice. The abstracts of a total of 2,622 papers which stated ACL in the title were investigated through a search on the Web of Knowledge. Main topics were created as the ACL reconstruction theme. ACL reconstruction was examined in the abstracts with graft choice as the main theme followed by single bundle, double bundle, sports, rehabilitation, revision, complication, skeletally immature, biomechanics and kinematics, fixation devices, meniscus, anesthesia and pain, tunnel, cell, and intra-articular injection. Of the total 2,622 documents, 2,129 were original articles and 181 were reviews. Most of the documents, 436 in number (16.6%), were published in the , followed by the, , at 264. Of the total documents published, 36.3% were from the United States followed by 8.5% from Japan. The author with the most publications was F.H. Fu with 94 publications followed by B.R. Bach with 41 publications. The hamstring graft was most used at 187 single use and comprising 52% of the total graft combinations. Most papers were published in 2016. In 2012, single and double bundle grafts were determined to a total of 23. The most common title investigated in papers was biomechanics and kinematics with a total of 241 publications followed by rehabilitation at 208. Throughout the years of the study period, the most common graft choice was hamstring autograft. Biomechanics and kinematics was the most common title investigated as biomechanics and rehabilitation are known to be just as important as surgery for a successful outcome and patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Yücens

Aydemir

2018

J Knee Surg

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“…One is graft soaking in vancomycin, which has been demonstrated to be effective. 16,17 Despite this, antibiotic treatment guidelines remain unclear.…”

Section: Discussionmentioning

confidence: 99%

Infections after Anterior Cruciate Ligament Reconstruction: Which Antibiotic after Arthroscopic Debridement?

et al. 2016

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Arthroscopic debridement has proven to be the optimal surgical treatment for infections of the anterior cruciate ligament reconstruction (ACLR). Nevertheless, there are no reported data for the best antibiotic treatment option and its duration. The purpose of this article is to assess the usefulness of oral levofloxacin and rifampicin for the treatment of acute infections of an ACLR. This is a retrospective observational cohort study of patients operated on for ACLR over 4 years. A diagnosis of septic arthritis was based on patients' anamnesis and physical examination, laboratory parameters, and cultures of synovial fluid and/or joint tissue. Arthroscopic lavage was performed as soon as possible and tissue samples were taken. At a minimum 2-year follow-up, the infection was considered cured with a normal C-reactive protein (CRP) level and a correctly functioning and pain-free knee. Of the 810 patients, 15 (1.8%) were diagnosed as having an infection. Among the 13 staphylococcal cases (86.6%), 10 were susceptible to both quinolones and rifampicin (76.9% of the staphylococcal infections). There were two staphylococci that were rifampicin resistant. In the remaining one case, the coagulase-negative staphylococcus (CNS) was resistant to quinolones. One CNS infection was treated with linezolid and rifampicin and was the only case that needed graft removal due to treatment failure. Antibiotic treatment lasted an average of 6 weeks and oral treatment started at a mean of 5 days (range, 4-7). In the remaining 12 patients, CRP levels returned to normal at a mean of 3 weeks with good knee function and no local symptoms. Staphylococci (especially CNS) are responsible for almost 90% of acute ACLR infections in the current series. For the first time, the combination of levofloxacin and rifampicin is being proposed as a treatment in cases of an acute staphylococcal infection of an ACLR. An early switch to oral antibiotic treatment (as soon as the cultures are available) with both levofloxacin and rifampicin for a total (empiric and directed) period of 6 weeks should be considered as treatment of choice in acute staphylococcal infections of the ACLR with a retained graft. level of evidence is IV (case series).

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“…With regard to new prophylactic measures described to decrease infection rate following ACLR, recent investigations demonstrated that presoaking the autograft in a diluted solution of vancomycin is effective for this purpose [24][25][26]. Other measures, such as the use of gentamicin irrigation solution, have been shown as less effective [27].…”

Section: Aetiopathologymentioning

confidence: 97%

Managing septic arthritis after knee ligament reconstruction

Torres-Claramunt

Gelber

Pelfort

et al. 2015

International Orthopaedics (SICOT)

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

Abstract: Case control study, retrospective comparative study, Level III.

Cited by 101 publications

References 26 publications

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Infections after Anterior Cruciate Ligament Reconstruction: Which Antibiotic after Arthroscopic Debridement?

Managing septic arthritis after knee ligament reconstruction

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