ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
There is no general use of thromboprophylaxis and prolonged antibiotic prophylaxis in anterior cruciate ligament reconstruction: a nation-wide survey of ACL surgeons in Sweden.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Thromboprophylaxis After ACL Reconstruction: Controversies and Future Challenges.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Influence of Surgeon Experience and Clinic Volume on Subjective Knee Function and Revision Rates in Primary ACL Reconstruction: A Study from the Swedish National Knee Ligament Registry.Orthopaedic journal of sports medicine · 2024Article
- Optimising the Early-Stage Rehabilitation Process Post-ACL Reconstruction.Sports medicine (Auckland, N.Z.) · 2024Review
- Patients return to sports and to work after successful treatment of septic arthritis following anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Incidence and risk factors for symptomatic venous thromboembolism following anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Venous Thromboembolism Prophylaxis and Hormonal Contraceptive Management Practice Patterns in the Perioperative Period for Anterior Cruciate Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2022Article
- Does anterior cruciate ligament reconstruction increase venous thromboembolism risk compared with knee meniscectomy under arthroscopy?BMC musculoskeletal disorders · 2022Article
- Vancomycin Presoaking of the Graft Appears to Prevent Infection After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2022Review
- Presoaking ACL Grafts in Vancomycin Decreases the Frequency of Postoperative Septic Arthritis: A Cohort Study of 29,659 Patients, Systematic Review, and Meta-analysis From the SANTI Study Group.Orthopaedic journal of sports medicine · 2022Article
- Compensation claims following anterior cruciate ligament injuries reported to the patient insurance company in Sweden in 2005-2014.Acta orthopaedica · 2022Article
- Surgeon practice patterns for pre-soaking ACL tendon grafts in vancomycin: a survey of the ACL study group.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Article
- Risk Factors for Septic Arthritis After Anterior Cruciate Ligament Reconstruction: A Nationwide Analysis of 26,014 ACL Reconstructions.The American journal of sports medicine · 2021Article
- Vancomycin presoaking of hamstring autografts to prevent infection in anterior cruciate ligament reconstruction: a narrative review.EFORT open reviews · 2021Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe use of prophylaxis for thromboembolism and infection in anterior cruciate ligament (ACL) reconstruction is not well documented and no general guidelines have been established. The aim of this study was to evaluate the ACL surgeons' individual strategies of thromboprophylaxis, use of prolonged antibiotic prophylaxis and vancomycin-soaked ACL grafts, and if its use is supported in the current literature. Additionally, the rationale for use of tourniquet was analysed.
methodsQuestionnaires were distributed to all Swedish ACL surgeons who are registered in the Swedish Knee Ligament Register (SKLR), asking about prescription of thromboprophylaxis, prolonged antibiotic prophylaxis, the use of vancomycin-soaked graft and the use of a tourniquet during surgery. The responses were assessed for agreement and the thromboprophylaxis data were analysed in relation to the 2016 SKLR data.
results115 (75%) ACL surgeons responded to the survey. 81.7% prescribed thromboprophylaxis only when risk factors, such as history of thrombosis and the use of oral contraceptives, were present. Female gender, older age and admitted patient were considered the risk factors with the lowest impact. The respondents were generally restrictive regarding the use of prolonged antibiotic prophylaxis. The use of vancomycin-soaked graft was used by only nine (8%) surgeons representing 406 (13%) of the surgeries.
conclusionSwedish ACL surgeons are generally restrictive using thromboprophylaxis and only when risk factors are present. However, there is a lack of consensus in how to weigh the different risk factors and it does not completely adhere to the existing literature. Prolonged antibiotic prophylaxis is rarely used and the use of vancomycin soaking of graft is very limited and applies only to a small number of surgeons. The use of tourniquet is common. There is a need for ACL-specific guidelines regarding the use of thromboprophylaxis. LEVEL OF EVIDENCE: IV.
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