Pre-soaking of hamstring grafts reduces risk of infection after ACL-reconstruction. A prospective study including 1000 patients

AIMS AND OBJECTIVES: Post-operative infection of the knee is one of the major concerns following ACL-reconstruction. The purpose of this study was to investigate whether the pre-soaking of hamstring grafts in vancomycin reduces the incidence of post-operative infection. MATERIALS AND METHODS: This prospective study included more than 1000 patients undergoing primary ACL-reconstruction over a period of 4 years. Group 1 received intra-operative iv-antibiotics without pre-soaking of the graft. Group 2 received iv-antibiotics and additionally the graft was bathed in a vancomycin solution of 5 mg/mL. RESULTS: In group 1, a total of 2,3% of the patients suffered a post-operative joint infection. In contrast, there were no post-operative infections in the second group (0%). Statistical analysis revealed a significantly reduced post-operative infection rate when bathing the autograft in vancomycin. CONCLUSION: Pre-soaking of hamstrings grafts with vancomycin combined with classical iv antibiotic prophylaxis reduced the rate of post-operative infection when compared to iv-antibiotics alone. This technique should be utilized to reduce the overall incidence of knee infections following ACL reconstruction.