SUMMARY
Background. Anterior cruciate ligament rupture is a frequent injury in sports and infection after reconstruction is rare (0.14-1.8%). Intravenous antibiotic prophylaxis and soaking of autografts with vancomycin (tendons are soaked into a compress that contains 100ml of NaCl mixed with 500 mg of vancomycin for 10-15 min) have been applied in order to avoid infection after ACL reconstruction. The aim of this study was to determine if hamstrings soaking with vancomycin leads to histopathological changes than can produce functional impairment in patient’s follow-up.
Methods. Assessment to the graft was made based on redundant tendon tissue from ACL reconstruction procedures of patients operated by the same surgeon. Tendons collected during surgery were used and surplus segments were submitted to histopathological study and elastin impregnation. Two samples from each tendon of eighteen patients were analyzed, with and without vancomycin impregnation.
Results. This study included 18 patients. The mean age at surgery was 29 years old, 83.3% were male and 16.7% female. There were no cases of documented septic arthritis. Our results showed a considerable reinforcement of elastin wavy configuration after soaking with vancomycin and apparent retraction of surrounding tissues.
Conclusions. Hamstrings autografts’ structure is altered after vancomycin soaking.
Histopathological analysis described in this study might produce a decrease in tendon resistance to tensile forces that was not correlated with an increased risk of rupture. Future studies are needed to clarify vancomycin effects on graft integrity.
Autograft Soaking in Vancomycin in Anterior Cruciate Ligament Reconstruction Alters Tendons Structure: an Histopathological Interpretation
C. Quintas, J. P. Oliveira, P. Marques, A. Inês, F. Fonseca
Original Article, 361-368
Keywords: "elastin, anterior cruciate ligament, antibiotic prophylaxis, collagen, fibroblasts, hamstrings autografts, knee infection, vancomycin,
Table of Content: Vol. 12 (No.3) 2022 July/September
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Autograft Soaking in Vancomycin in Anterior Cruciate Ligament Reconstruction Alters Tendons Structure: an Histopathological Interpretation
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