Fatima Kayali
Introduction
To determine whether there is any difference in graft rerupture rates and clinical outcomes between cases having vancomycin graft presoaking vs. no vancomycin presoaking in anterior cruciate ligament (ACL) reconstruction (ACLR).
Methods:
Systematic review and meta-analysis. PubMed, Embase, CINAHL, and Cochrane CENTRAL were searched. Full published studies reporting on the relation between vancomycin graft presoaking and rates of graft rerupture and/or clinical outcomes in ACLR surgery vs. no vancomycin graft presoaking were included. Meta-analysis was conducted using a random effects model.
Results
The literature search identified 907 records. After removing duplicates and those not meeting inclusion criteria, 8 studies were included. Meta-analysis showed that the estimated risk of hamstring graft rerupture was lower in cases presoaked with vancomycin vs. those having no presoaking (3.2% vs. 6.2% rerupture rate, risk ratio [RR] = 0.507, 95% CI, 0.39-0.737, p < 0.001). Similarly, the estimated risk of graft rerupture was lower in cases presoaked with vancomycin vs. those having no presoaking when the analysis included various ACL graft types (2.7% vs. 3.9% rerupture rate, RR = 0.557, 95% confidence interval [CI], 0.403-0.771, p < 0.001).
Conclusion
Vancomycin graft presoaking is a safe practice and does not compromise ACL graft rerupture rates or clinical outcomes.
Authors
Charalambos P Charalambous, Blackpool Teaching Hospitals NHS Trust, Blackpool, United Kingdom & School of Medicine, University of Central Lancashire, Preston, United Kingdom
Emadeldin M. Ahmed, Blackpool Teaching Hospitals NHS Trust, Blackpool, United Kingdom
Fatima Kayali, Mersey and West Lancashire NHS Teaching Hospital, Prescot, United Kingdom
Hritik Nautiyal, Watford General Hospital, Watford, United Kingdom
Kenan BA Kuršumović, The Royal Melbourne Hospital, Melbourne, Australia
Paul M. Sutton, Northern General Hospital, Sheffield, United Kingdom