The vancomycin soaking technique: no differences in autograft re-rupture rate. A comparative study
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ORIGINAL PAPER
The vancomycin soaking technique: no differences in autograft re-rupture rate. A comparative study Daniel Pérez-Prieto 1,2 & Simone Perelli 2 & Ferran Corcoll 1 & Gonzalo Rojas 3 & Verónica Montiel 4 & Juan Carlos Monllau 1,2 Received: 4 July 2020 / Accepted: 8 September 2020 # SICOT aisbl 2020
Abstract Purpose The main aim of this study was to evaluate the re-rupture risk after an anterior cruciate ligament reconstruction (ACL-R) using the vancomycin soaking technique and to compare it with the re-rupture risk in patients on whom this technique was not utilized. The secondary purpose was to compare the functional outcomes of those two subsets of patients operated on for ACL-R. The hypotheses are that the vancomycin soaking technique does not affect the re-rupture risk or the functional outcomes. Material and methods A retrospective historical cohort study was conducted. Two groups were compared in terms of the re-rupture rate (traumatic or atraumatic) and functional outcomes (International Knee Documentation Committee (IKDC), Tegner, and Lysholm). Group 1 consisted of patients that received pre-operative IV antibiotics. In group 2, the patients received pre-operative IV antibiotics along with a graft that had been presoaked in a vancomycin solution. A minimum follow-up of five years was required. Results There were 17 patients that suffered a re-rupture in group 1 (4.7%) and 15 in group 2 (3.9%) (n.s.). IKDC was 82.0 in group 1 and 83.9 in group 2 (p = 0.049); Tegner scored 4 in both groups (n.s.) and Lysholm was 90.3 in group 1 and 92.0 in group 2 (p = 0.015). Conclusion The vancomycin soaking technique for ACL autografts is a safe procedure for the daily clinical practice, in terms of re-ruptures. Moreover, it does not impair functional outcomes after an ACL-R. Keywords ACL infection . Vancomycin technique . ACL reconstruction . Infection prevention . Orthopaedic infection
Introduction Anterior cruciate ligament reconstruction (ACL-R) is a common orthopaedic procedure, being one of the most frequent surgical procedures in the sports medicine field [1, 2]. The number of studies published in PubMed rises every year,
Level of evidence: Level III. Historical cohort study * Daniel Pérez-Prieto [email protected] 1
Department of Traumatology and Orthopaedic Surgery, Hospital del Mar–Universitat Autònoma de Barcelona (UAB), Passeig Marítim, 25, 08003 Barcelona, Spain
2
Catalan Institute for Traumatology and Sports Medicine (ICATME), Hospital Universitari Dexeus.–Universitat Autònoma de Barcelona (UAB), Sabino Arana 5-19, 08028 Barcelona, Spain
3
Hospital Regional Talca, Universidad Católica de Maule, Talca, Chile
4
Clínica Universitaria de Navarra, Pamplona, Spain
reaching approximately 7000 studies only in the last five years. However, most of them relate to anatomy, surgical techniques, and rehabilitation. There are very few about ACLR infections [3–6]. Nevertheless, an infection can turn out to be a serious complication, especially if proper treatment is not applied. The infec
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