Burton Michael, Barker Tyler, Burnett Zachary, Magnussen Robert, Kaeding Christopher, Milliron Eric, Cavendish Parker, Piscitani Franco, Seidt Jeremy, Flanigan David
Boonshoft School of Medicine, Wright State University, Dayton, Ohio, USA.
Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Orthop J Sports Med. 2025 Mar 25;13(3):23259671251325663. doi: 10.1177/23259671251325663. eCollection 2025 Mar.
Tendon graft soaking in vancomycin solution minimizes surgical infection risk and has no effect on graft strength, but the intermittent vancomycin shortages, presence of vancomycin-resistant organisms, and treatment needs of patients with vancomycin hypersensitivity merit investigation of alternative antibiotics. Tobramycin prevents infection at low concentrations and is a cost-effective alternative, but it is unknown if tobramycin alters graft mechanical properties.
PURPOSE/HYPOTHESIS: The purpose of this study was to investigate the effects of tobramycin soaking on tendon graft mechanical properties. It was hypothesized that tobramycin soaking will not affect tendon graft mechanical properties.
Controlled laboratory study.
A total of 30 tibialis tendon grafts were wrapped in saturated gauze swabs containing saline (control; n = 10), vancomycin (n = 10; 5 mg/mL), or tobramycin (n = 10; 1 mg/mL) for 10 minutes. Grafts were then removed from the treated gauze swab wraps and mechanically tested under uniaxial tension loading conditions. Grafts were pulled at a rate of 10 mm/min to failure. Force and displacement data from each test were used to calculate the Young modulus (MPa), ultimate tensile stress (MPa), and elasticity limit (MPa).
There were no significant differences in Young modulus (552 ± 108, 583 ± 98, and 660 ± 237 MPa; = .62), ultimate tensile stress (91.5 ± 20.8, 96.6 ± 17.8, and 99.7 ± 33.3 MPa; = .85), or elasticity limit (51.7 ± 16.4, 53.2 ± 13.8, and 52.3 ± 15.3 MPa; = .98) between the control, vancomycin, and tobramycin groups, respectively.
Soaking of tibialis tendon grafts with tobramycin does not appear to alter mechanical properties of the tendon graft under uniaxial load conditions.
If vancomycin use is not possible or contraindicated for certain patients, surgeons can soak grafts in tobramycin to achieve similarly effective infection mitigation without weakening the graft.
将肌腱移植物浸泡在万古霉素溶液中可将手术感染风险降至最低，且对移植物强度无影响，但万古霉素间歇性短缺、耐万古霉素微生物的存在以及万古霉素过敏患者的治疗需求值得对替代抗生素进行研究。妥布霉素在低浓度时可预防感染，是一种具有成本效益的替代药物，但尚不清楚妥布霉素是否会改变移植物的机械性能。
目的/假设：本研究的目的是探讨妥布霉素浸泡对肌腱移植物机械性能的影响。假设是妥布霉素浸泡不会影响肌腱移植物的机械性能。
对照实验室研究。
将总共30条胫骨肌腱移植物用含有生理盐水（对照组；n = 10）、万古霉素（n = 10；5 mg/mL）或妥布霉素（n = 10；1 mg/mL）的饱和纱布拭子包裹10分钟。然后将移植物从处理过的纱布拭子包裹中取出，并在单轴拉伸加载条件下进行机械测试。以10 mm/min的速率拉动移植物直至断裂。每次测试的力和位移数据用于计算杨氏模量（MPa）、极限拉伸应力（MPa）和弹性极限（MPa）。
对照组、万古霉素组和妥布霉素组之间的杨氏模量（552±108、583±98和660±237 MPa；P = 0.62）、极限拉伸应力（91.5±20.8、96.6±17.8和99.7±33.3 MPa；P = 0.85）或弹性极限（51.7±16.4、53.2±13.8和52.3±15.3 MPa；P = 0.98）均无显著差异。
在单轴负载条件下，用妥布霉素浸泡胫骨肌腱移植物似乎不会改变肌腱移植物的机械性能。
如果某些患者无法使用或禁忌使用万古霉素，外科医生可以将移植物浸泡在妥布霉素中，以在不削弱移植物的情况下实现类似的有效感染缓解。
