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Research Paper | Orthopaedic Surgery | Malaysia | Volume 12 Issue 7, July 2023 | Rating: 6 / 10

Relevance of Intra - Operative Vancomycin Hamstring Autograft Soaking in Primary Anterior Cruciate Ligament Reconstruction

Yuzaimi Yaakub | Ibrahim Ahmad Fuad | Muhd Maliki Muhd Nawawi | Zulkifli Hassan | Saadon Ibrahim ^[2]

Abstract: Background: To investigate the relevance of hamstring autograft soaking with vancomycin reduces postoperative infection rate after primary Anterior Cruciate Ligament Reconstruction (ACLR). Objective(s): To compare the rate of postoperative infection rate between the vancomycin graft soaking group and non-soaking group, as well as to find the association between patient demographic factors (age, gender, BMI, smoking, and duration of surgery) with postoperative infection following primary ACLR. Method: Retrospective medical record review of all primary ACL reconstructions using hamstring autograft over a 4-year in a government hospital. The patients only received standard prophylactic IV antibiotics in the initial 2-year period (Group A). In the following 2-year period, the patients received prophylactic IV antibiotics and a vancomycin solution soaked into the graft (Group B). Results: There were 74 patients, of which 33 were in Group A, and 41 were in Group B, respectively. Five cases of postoperative infections were identified in the population (6.76%). Four patients were found in group A, contributing a rate of infection of 12.12% in comparison with 1 case of postoperative infection (2.44%) in group B (p > 0.005). In the model to estimate the association of patient demographic factors (age, gender, BMI, smoking, and duration of surgery) between postoperative infection rate in autograft soaking with vancomycin group and non-soaking autograft group in primary ACL reconstructions, we found there were no statistically significant risk factors in our analysis (p-value >0.25). Conclusions: The additional technique of hamstring autograft soaking with vancomycin solution compared to a single prophylactic IV antibiotic could reduce the incidence of postoperative infection after primary ACLR. Antibiotic graft soaking may be relevant as an additional prophylaxis measure to prevent postoperative infection after ACLR.

Keywords: Vancomycin, postoperative infection, anterior cruciate ligament, graft soaking

Edition: Volume 12 Issue 7, July 2023,

Pages: 1933 - 1937