Assessing the Outcomes of Anterior Cruciate Ligament Reconstruction with or without the use of Antibiotic Solution in...

Reconstruction of ligament injuries, particularly the anterior cruciate ligament, is a widely accepted approach for restoring knee function in anterior cruciate ligament (ACL) deficiency; however, postoperative infections remain a serious complication. Presoaking grafts in antibiotic solutions offers protective benefits against infection by providing local antibiotic prophylaxis without affecting graft integrity. No high-quality RCTs in India have evaluated this infection prevention method.

In this prospective RCT at a tertiary center, 76 patients with complete ACL tears were allocated to presoaking of ACL grafts in either vancomycin solution (500 mg/100 mL saline for 10-15 min) in the experimental group or presoaking of ACL grafts in normal saline in the control group before implantation. A simple randomization technique using sealed opaque envelopes ensured unbiased allocation. The primary outcome was postoperative infection measured via C-reactive protein levels postoperatively to monitor the inflammatory response. Functional outcomes were assessed using the International Knee Documentation Committee (IKDC) and Lysholm Knee score at 6 months.

This study aims to evaluate the effectiveness of vancomycin presoaking of ACL grafts in reducing postoperative infection rates in patients undergoing ACLR. The vancomycin presoaked ACL grafts group ( n = 38) had 0% infection versus 5.26% in the saline presoaked ACL grafts group ( n = 38) ( P = 0.152). No graft failures occurred in both groups. Mean IKDC scores were 87.02 ± 6.75 in the vancomycin presoaked grafts group versus 87.19 ± 6.24 in the saline presoaked grafts group ( P = 0.838), and mean Lysholm scores were 83.68 ± 7.66 in the vancomycin presoaked grafts group versus 86.47 ± 6.38 in the saline presoaked grafts group ( P > 0.05), respectively.

Vancomycin presoaking of ACL grafts is safe and shows a trend towards lower infection risk without adverse effects on graft performance or recovery.