Vancomycin soaking of ACL reconstructions does not alter the mechanical strength

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Infectious Disease Prevention

Background:

• Anterior cruciate ligament (ACL) reconstruction with hamstring autografts has a 0.5%–1.5% infection risk.
• Vancomycin soaking of grafts shows potential for near-zero infection rates.
• In vitro studies confirmed vancomycin's non-toxicity to tenocytes.

Purpose of the Study:

• To assess the mechanical quality of vancomycin-soaked hamstring tendon transplants at 6 months post-surgery.
• To evaluate the rate of new graft rupture at 1 year following ACL reconstruction.

Main Methods:

• Retrospective, single-center study of 53 patients undergoing ACL reconstruction with vancomycin-soaked grafts.
• Objective laxity assessment using GNRB® at 6 months.
• Clinical evaluation with Lysholm and IKDC questionnaires at 1 year.

Main Results:

• Graft mechanical quality at 6 months was significantly different but below rupture thresholds.
• Knee stability post-reconstruction was comparable to the contralateral knee.
• Early graft rupture occurred in 3.8% of patients due to technical graft positioning issues.

Conclusions:

• Vancomycin soaking of hamstring autografts for ACL reconstruction appears safe and effective.
• The method preserves graft mechanical quality and achieves comparable knee stability.
• Further research into graft positioning techniques may further reduce rupture rates.