Evidence map›Paper›PMID 32363476›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021

Soaking of autografts with vancomycin is highly effective on preventing postoperative septic arthritis in patients undergoing ACL reconstruction with hamstrings autografts.

Konstantinos Banios, George A Komnos, Vasilios Raoulis, Metaxia Bareka, George Chalatsis, Michael E Hantes

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Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.

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  11. In Vitro Study of Gentamicin Elution from Tendon Grafts.Indian journal of orthopaedics · 2023
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  17. 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 · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Konstantinos BaniosDepartment of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.
George A KomnosDepartment of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.
Vasilios RaoulisDepartment of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.
Metaxia BarekaAnesthesiology Department, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, Larissa, Greece.
George ChalatsisDepartment of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, Mezourlo, 41110, Larissa, Greece.
Michael E HantesDepartment of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Hospital of Larissa, Mezourlo, 41110, Larissa, Greece. hantesmi@otenet.gr.ORCID http://orcid.org/0000-0001-9494-6048
University Hospital of Larissa · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the impact of local soaking of the autografts with vancomycin during anterior cruciate ligament (ACL) reconstruction on postoperative infection rates.

methodsBetween 2003 and 2014 (first study period), 1,242 patients underwent ACL reconstruction using autografts, without soaking them in vancomycin solution, while between 2014 and 2019 (second study period) all ACL autografts in 593 patients were soaked in a 5-mg/ml vancomycin solution, in a territory University Hospital. The same standard treatment of perioperative IV antibiotics was applied in both groups.

resultsPostoperative septic arthritis occurred in seven out of 1,242 patients (0.56%) during the first study period. Bone patellar tendon bone autograft was used in 311 (25%) patients, and hamstring tendon autograft was used in the rest 931 (75%) of the study population during this period. All infected cases were male and had a hamstrings graft implanted. There were no postoperative infections (0%) in 593 ACL reconstructions during the second study period. Bone patellar tendon bone autograft was used in 178 (30%) patients while hamstring tendon autograft was used in the rest 415 (70%) of the study population, during this period. Statistical analysis revealed a significantly reduced postoperative infection rate (p = 0.018) between the two reported periods, with the main impact referring to the use of hamstrings autograft (p = 0.031) for the first study period.

conclusionsSeptic arthritis following ACL reconstruction can be significantly reduced (or even eliminated) by soaking ACL autografts in a 5 mg/ml vancomycin solution. Of note, this strategy seems to be more effective in the setting of hamstring tendon autograft use, since the risk of postoperative knee infection is significantly higher when this type of graft is used.

Indexed as

AutograftsAdultAnterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionAnti-Bacterial AgentsArthritis, InfectiousBone-Patellar Tendon-Bone GraftingFemaleHamstring TendonsHumansMalePostoperative ComplicationsTransplantation, AutologousVancomycinAnti-Bacterial AgentsVancomycinAnterior cruciate ligament reconstructionGraft soakingKnee infectionVancomycin

Identifiers

PMID32363476
OpenAlexW3022997589

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.