Comparison Between Vancomycin and Gentamicin for Intraoperative Presoaking of Hamstring Graft in Primary Anterior Cruciate Ligament Reconstruction
Introduction Postoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking of the hamstring graft with antibiotics results in a lower rate of infection. The purpose of the current study was to compare the efficacy o...
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Published in | Curēus (Palo Alto, CA) Vol. 14; no. 2; p. e22550 |
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Language | English |
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23.02.2022
Cureus |
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Abstract | Introduction Postoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking of the hamstring graft with antibiotics results in a lower rate of infection. The purpose of the current study was to compare the efficacy of two commonly used antibiotics, vancomycin and gentamicin, in reducing infection rates following anterior cruciate ligament reconstruction. Methods The retrospective study included a total of 578 patients who underwent arthroscopic anterior cruciate ligament reconstruction between June 2015 and October 2021. The timeline was categorized as the period between June 2015 to October 2018 (Vancomycin presoaking of hamstring graft) and November 2018 to October 2021 (Gentamicin presoaking of hamstring graft). All patients were examined for the development of infection, causative organism, and treatment received. Patients with intravenous drug abuse, alcoholism, steroid use, revision cases, and a prior history of infection in the knee were excluded from the study. Fisher's exact test was used for comparison of categorical data, and Poisson regression analysis was carried out to calculate incidence rate ratios after adjusting for confounding variables. Results Presoaking of hamstring grafts with vancomycin was carried out in 224 patients, and gentamicin was used in 354 patients. In total, three patients in the vancomycin and four patients in the gentamicin groups developed an intraarticular infection, and the difference in infection rate between the two groups was not statistically significant (p=0.919). Coagulase-negative
was isolated in four cases, Enterobacter cloacae in one, and no organism was seen in two cases. The groups were comparable in terms of age (p=0.563), smoking (p=0.84), sex (p=0.359), and operative time (p=0.09). Conclusion Presoaking of hamstring autografts with gentamicin intraoperatively is a good alternative to vancomycin in the prevention of infection following arthroscopic anterior cruciate ligament reconstruction. |
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AbstractList | IntroductionPostoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking of the hamstring graft with antibiotics results in a lower rate of infection. The purpose of the current study was to compare the efficacy of two commonly used antibiotics, vancomycin and gentamicin, in reducing infection rates following anterior cruciate ligament reconstruction.MethodsThe retrospective study included a total of 578 patients who underwent arthroscopic anterior cruciate ligament reconstruction between June 2015 and October 2021. The timeline was categorized as the period between June 2015 to October 2018 (Vancomycin presoaking of hamstring graft) and November 2018 to October 2021 (Gentamicin presoaking of hamstring graft). All patients were examined for the development of infection, causative organism, and treatment received. Patients with intravenous drug abuse, alcoholism, steroid use, revision cases, and a prior history of infection in the knee were excluded from the study. Fisher’s exact test was used for comparison of categorical data, and Poisson regression analysis was carried out to calculate incidence rate ratios after adjusting for confounding variables.ResultsPresoaking of hamstring grafts with vancomycin was carried out in 224 patients, and gentamicin was used in 354 patients. In total, three patients in the vancomycin and four patients in the gentamicin groups developed an intraarticular infection, and the difference in infection rate between the two groups was not statistically significant (p=0.919). Coagulase-negative Staphylococcus aureus was isolated in four cases, Enterobacter cloacae in one, and no organism was seen in two cases. The groups were comparable in terms of age (p=0.563), smoking (p=0.84), sex (p=0.359), and operative time (p=0.09).ConclusionPresoaking of hamstring autografts with gentamicin intraoperatively is a good alternative to vancomycin in the prevention of infection following arthroscopic anterior cruciate ligament reconstruction. Introduction Postoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking of the hamstring graft with antibiotics results in a lower rate of infection. The purpose of the current study was to compare the efficacy of two commonly used antibiotics, vancomycin and gentamicin, in reducing infection rates following anterior cruciate ligament reconstruction. Methods The retrospective study included a total of 578 patients who underwent arthroscopic anterior cruciate ligament reconstruction between June 2015 and October 2021. The timeline was categorized as the period between June 2015 to October 2018 (Vancomycin presoaking of hamstring graft) and November 2018 to October 2021 (Gentamicin presoaking of hamstring graft). All patients were examined for the development of infection, causative organism, and treatment received. Patients with intravenous drug abuse, alcoholism, steroid use, revision cases, and a prior history of infection in the knee were excluded from the study. Fisher's exact test was used for comparison of categorical data, and Poisson regression analysis was carried out to calculate incidence rate ratios after adjusting for confounding variables. Results Presoaking of hamstring grafts with vancomycin was carried out in 224 patients, and gentamicin was used in 354 patients. In total, three patients in the vancomycin and four patients in the gentamicin groups developed an intraarticular infection, and the difference in infection rate between the two groups was not statistically significant (p=0.919). Coagulase-negative was isolated in four cases, Enterobacter cloacae in one, and no organism was seen in two cases. The groups were comparable in terms of age (p=0.563), smoking (p=0.84), sex (p=0.359), and operative time (p=0.09). Conclusion Presoaking of hamstring autografts with gentamicin intraoperatively is a good alternative to vancomycin in the prevention of infection following arthroscopic anterior cruciate ligament reconstruction. Introduction Postoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking of the hamstring graft with antibiotics results in a lower rate of infection. The purpose of the current study was to compare the efficacy of two commonly used antibiotics, vancomycin and gentamicin, in reducing infection rates following anterior cruciate ligament reconstruction. Methods The retrospective study included a total of 578 patients who underwent arthroscopic anterior cruciate ligament reconstruction between June 2015 and October 2021. The timeline was categorized as the period between June 2015 to October 2018 (Vancomycin presoaking of hamstring graft) and November 2018 to October 2021 (Gentamicin presoaking of hamstring graft). All patients were examined for the development of infection, causative organism, and treatment received. Patients with intravenous drug abuse, alcoholism, steroid use, revision cases, and a prior history of infection in the knee were excluded from the study. Fisher’s exact test was used for comparison of categorical data, and Poisson regression analysis was carried out to calculate incidence rate ratios after adjusting for confounding variables. Results Presoaking of hamstring grafts with vancomycin was carried out in 224 patients, and gentamicin was used in 354 patients. In total, three patients in the vancomycin and four patients in the gentamicin groups developed an intraarticular infection, and the difference in infection rate between the two groups was not statistically significant (p=0.919). Coagulase-negative Staphylococcus aureus was isolated in four cases, Enterobacter cloacae in one, and no organism was seen in two cases. The groups were comparable in terms of age (p=0.563), smoking (p=0.84), sex (p=0.359), and operative time (p=0.09). Conclusion Presoaking of hamstring autografts with gentamicin intraoperatively is a good alternative to vancomycin in the prevention of infection following arthroscopic anterior cruciate ligament reconstruction. |
Author | Malhotra, Neeraj Bansal, Deepak Lakhani, Amit Dahuja, Anshul Khatri, Kavin |
AuthorAffiliation | 5 Orthopaedics, Government Medical College, Amritsar, Amritsar, IND 4 Orthopaedics, Dr. B.R. Ambedkar State Institute of Medical Sciences, Mohali, IND 3 Orthopaedics, Guru Gobind Singh Medical College, Faridkot, Faridkot, IND 2 Orthopaedics, All India Institute of Medical Sciences, Bathinda, Bathinda, IND 1 Orthopaedics and Traumatology, AIMC Bassi Hospital and Ludhiana Mediways Hospital, Ludhiana, IND |
AuthorAffiliation_xml | – name: 1 Orthopaedics and Traumatology, AIMC Bassi Hospital and Ludhiana Mediways Hospital, Ludhiana, IND – name: 3 Orthopaedics, Guru Gobind Singh Medical College, Faridkot, Faridkot, IND – name: 5 Orthopaedics, Government Medical College, Amritsar, Amritsar, IND – name: 4 Orthopaedics, Dr. B.R. Ambedkar State Institute of Medical Sciences, Mohali, IND – name: 2 Orthopaedics, All India Institute of Medical Sciences, Bathinda, Bathinda, IND |
Author_xml | – sequence: 1 givenname: Deepak surname: Bansal fullname: Bansal, Deepak organization: Orthopaedics and Traumatology, AIMC Bassi Hospital and Ludhiana Mediways Hospital, Ludhiana, IND – sequence: 2 givenname: Kavin surname: Khatri fullname: Khatri, Kavin organization: Orthopaedics, All India Institute of Medical Sciences, Bathinda, Bathinda, IND – sequence: 3 givenname: Anshul surname: Dahuja fullname: Dahuja, Anshul organization: Orthopaedics, Guru Gobind Singh Medical College, Faridkot, Faridkot, IND – sequence: 4 givenname: Amit surname: Lakhani fullname: Lakhani, Amit organization: Orthopaedics, Dr. B.R. Ambedkar State Institute of Medical Sciences, Mohali, IND – sequence: 5 givenname: Neeraj surname: Malhotra fullname: Malhotra, Neeraj organization: Orthopaedics, Government Medical College, Amritsar, Amritsar, IND |
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Keywords | gentamicin anterior cruciate ligament reconstruction vancomycin infection septic arthritis |
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Snippet | Introduction Postoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking... IntroductionPostoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking... Introduction Postoperative infection is an uncommon complication with grave consequences following anterior cruciate ligament reconstruction (ACLR). Presoaking... |
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StartPage | e22550 |
SubjectTerms | Antibiotics Arthritis Body mass index Demographics Diabetes Hospitals Infections Infectious Disease Knee Ligaments Orthopedics Skin Statistical analysis Surgeons |
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Title | Comparison Between Vancomycin and Gentamicin for Intraoperative Presoaking of Hamstring Graft in Primary Anterior Cruciate Ligament Reconstruction |
URI | https://www.ncbi.nlm.nih.gov/pubmed/35345679 https://www.proquest.com/docview/2645761128/abstract/ https://search.proquest.com/docview/2644951088 https://pubmed.ncbi.nlm.nih.gov/PMC8956929 |
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