Department of Traumatology and Orthopaedic Surgery, Hospital del Mar-Universitat Autònoma de Barcelona (UAB), Passeig Marítim, 25, 08003, Barcelona, Spain.
Catalan Institute for Traumatology and Sports Medicine (ICATME), Hospital Universitari Dexeus.-Universitat Autònoma de Barcelona (UAB), Sabino Arana 5-19, 08028, Barcelona, Spain.
Int Orthop. 2021 Jun;45(6):1407-1411. doi: 10.1007/s00264-020-04805-5. Epub 2020 Sep 17.
The main aim of this study was to evaluate the re-rupture risk after an anterior cruciate ligament reconstruction (ACL-R) using the vancomycin soaking technique and to compare it with the re-rupture risk in patients on whom this technique was not utilized. The secondary purpose was to compare the functional outcomes of those two subsets of patients operated on for ACL-R. The hypotheses are that the vancomycin soaking technique does not affect the re-rupture risk or the functional outcomes.
A retrospective historical cohort study was conducted. Two groups were compared in terms of the re-rupture rate (traumatic or atraumatic) and functional outcomes (International Knee Documentation Committee (IKDC), Tegner, and Lysholm). Group 1 consisted of patients that received pre-operative IV antibiotics. In group 2, the patients received pre-operative IV antibiotics along with a graft that had been presoaked in a vancomycin solution. A minimum follow-up of five years was required.
There were 17 patients that suffered a re-rupture in group 1 (4.7%) and 15 in group 2 (3.9%) (n.s.). IKDC was 82.0 in group 1 and 83.9 in group 2 (p = 0.049); Tegner scored 4 in both groups (n.s.) and Lysholm was 90.3 in group 1 and 92.0 in group 2 (p = 0.015).
The vancomycin soaking technique for ACL autografts is a safe procedure for the daily clinical practice, in terms of re-ruptures. Moreover, it does not impair functional outcomes after an ACL-R.
本研究的主要目的是评估使用万古霉素浸泡技术进行前交叉韧带重建（ACL-R）后的再断裂风险，并将其与未使用该技术的患者的再断裂风险进行比较。次要目的是比较这两组接受 ACL-R 手术的患者的功能结果。假设是万古霉素浸泡技术不会影响再断裂风险或功能结果。
进行了回顾性历史队列研究。比较了两组的再断裂率（创伤性或非创伤性）和功能结果（国际膝关节文献委员会（IKDC）、Tegner 和 Lysholm）。第 1 组包括接受术前 IV 抗生素治疗的患者。在第 2 组中，患者接受术前 IV 抗生素治疗，并将移植物浸泡在万古霉素溶液中。需要至少 5 年的随访。
第 1 组有 17 例患者（4.7%）和第 2 组有 15 例患者（3.9%）发生再断裂（无统计学意义）。第 1 组的 IKDC 为 82.0，第 2 组为 83.9（p=0.049）；两组的 Tegner 评分均为 4（无统计学意义），Lysholm 评分第 1 组为 90.3，第 2 组为 92.0（p=0.015）。
ACL 自体移植物使用万古霉素浸泡技术是一种安全的日常临床操作，不会增加再断裂风险。此外，它不会影响 ACL-R 后的功能结果。
