PURPOSE To evaluate the impact of local soaking of the autografts with vancomycin during anterior cruciate ligament (ACL) reconstruction on postoperative infection rates. METHODS Between 2003 and 2014 (first study period), 1,242 patients underwent ACL reconstruction using autografts, without soaking them in vancomycin solution, while between 2014 and 2019 (second study period) all ACL autografts in 593 patients were soaked in a 5-mg/ml vancomycin solution, in a territory University Hospital. The same standard treatment of perioperative IV antibiotics was applied in both groups. RESULTS Postoperative septic arthritis occurred in seven out of 1,242 patients (0.56%) during the first study period. Bone patellar tendon bone autograft was used in 311 (25%) patients, and hamstring tendon autograft was used in the rest 931 (75%) of the study population during this period. All infected cases were male and had a hamstrings graft implanted. There were no postoperative infections (0%) in 593 ACL reconstructions during the second study period. Bone patellar tendon bone autograft was used in 178 (30%) patients while hamstring tendon autograft was used in the rest 415 (70%) of the study population, during this period. Statistical analysis revealed a significantly reduced postoperative infection rate (p = 0.018) between the two reported periods, with the main impact referring to the use of hamstrings autograft (p = 0.031) for the first study period. CONCLUSIONS Septic arthritis following ACL reconstruction can be significantly reduced (or even eliminated) by soaking ACL autografts in a 5 mg/ml vancomycin solution. Of note, this strategy seems to be more effective in the setting of hamstring tendon autograft use, since the risk of postoperative knee infection is significantly higher when this type of graft is used.

中文翻译：

---

万古霉素浸泡自体移植物对于预防自体绳肌腱重建ACL的患者术后败血性关节炎非常有效。

目的评估在前交叉韧带（ACL）重建过程中万古霉素局部浸泡自体移植物对术后感染率的影响。方法在2003年至2014年（第一个研究期）中，将1,242例患者使用自体移植物进行ACL重建，未将其浸泡在万古霉素溶液中；而在2014年至2019年（第二个研究期），将593例患者的所有ACL自体移植物均浸泡在5 mg / ml在当地大学医院的万古霉素溶液中。两组均采用围手术期静脉使用抗生素的相同标准治疗方法。结果在第一个研究期间，在1,242例患者中有7例发生了术后败血症性关节炎（0.56％）。311例（25％）患者使用了pa骨腱自体骨移植，在此期间，其余931个研究对象（75％）使用了绳肌腱自体移植。所有感染的病例均为男性，并植入了绳肌。在第二个研究期间，在593例ACL重建中没有术后感染（0％）。在此期间，有178例（30％）患者使用了骨pa腱自体移植，而其余415例（70％）使用了绳肌腱自体移植。统计分析表明，在两个报告的时期之间，术后感染率显着降低（p = 0.018），主要影响是在第一个研究期间使用了string绳肌自体移植（p = 0.031）。结论通过将ACL自体移植物浸泡在5 mg / ml万古霉素溶液中，可以显着减少（甚至消除）ACL重建后的脓毒性关节炎。