Assessing the Outcomes of Anterior Cruciate Ligament Reconstruction with or without the use of Antibiotic Solution in Graft Preparation: A Randomized Control Trial.
Kumar Gourab, Sudha Rani, Govind Kumar Gupta et al.
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In 30 seconds
This prospective randomized controlled trial at a tertiary centre compared vancomycin- with saline-presoaked grafts in 76 patients undergoing reconstruction for complete anterior cruciate ligament tears. At 6 months, infection occurred in 0% of the vancomycin group and 5.26% of the saline group (P = 0.152), a difference that was not statistically significant. No graft failures occurred. IKDC and Lysholm functional scores were similar between groups. The findings suggest a possible reduction in infection with vancomycin presoaking, without an observed difference in graft failure or functional recovery.
Key findings
- Infection was 0% with vancomycin presoaking versus 5.26% with saline presoaking (P = 0.152).
- No graft failures occurred in either group.
- Mean IKDC scores were 87.02 ± 6.75 versus 87.19 ± 6.24 (P = 0.838) for vancomycin and saline, respectively.
- Mean Lysholm scores were 83.68 ± 7.66 versus 86.47 ± 6.38 (P > 0.05), respectively.
Why it matters
Postoperative infection is a serious complication of ACL reconstruction, and graft presoaking is a local prophylactic approach evaluated in this trial. The observed infection difference may be clinically relevant, but the result was not statistically significant. Similar functional scores and the absence of graft failures provide short-term outcome data, while not establishing that vancomycin prevents infection.
What to keep in mind
The trial included 76 patients at a single tertiary centre, and functional outcomes were assessed at 6 months. The infection difference was not statistically significant.