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

被引:24
作者
Schuster, Philipp [1 ,2 ]
Schlumberger, Michael [1 ,3 ]
Mayer, Philipp [1 ]
Eichinger, Martin [1 ]
Gesslein, Markus [2 ]
Reddemann, Friederike [2 ]
Richter, Joerg [1 ]
机构
[1] Orthped Hosp Markgroeningen, Ctr Sports Orthoped & Special Joint Surg, Kurt Lindemann Weg 10, D-71706 Markgroeningen, Germany
[2] Paracelsus Med Private Univ, Dept Orthoped & Traumatol, Clin Nuremberg, Nurnberg, Germany
[3] Univ Hosp Innsbruck, Dept Trauma Surg, Innsbruck, Austria
关键词
ACL; Anterior cruciate ligament; Complication; Infection; Septic arthritis; Vancomycin; Presoaking; Local; Antibiotic; LOCAL VANCOMYCIN; ACL RECONSTRUCTION; MANAGEMENT; INFECTIONS; POWDER; KNEE;
D O I
10.1007/s00167-020-05882-0
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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.
引用
收藏
页码:2587 / 2591
页数:5
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