ArticleOrthopaedic journal of sports medicine2022
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.
Article in Orthopaedic journal of sports medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06166381 (Parenteral Versus Combined Parenteral With Vancomycin-soaked Graft in Decreasing the Risk of Infection in ACL Reconstruction Surgery), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled 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.
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.
Parenteral Versus Combined Parenteral With Vancomycin-soaked Graft in Decreasing the Risk of Infection in ACL Reconstruction Surgery: A Randomized Controlled Trial
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Vancomycin presoak reduces infection in anterior cruciate ligament reconstruction: a systematic review and meta-analysis.BMC musculoskeletal disorders · 2023Pooled it
- Assessing the Outcomes of Anterior Cruciate Ligament Reconstruction with or without the use of Antibiotic Solution in Graft Preparation: A Randomized Control Trial.Annals of African medicine · 2026Trial
- Article
- Pretreatment With Vancomycin Prevents Staphylococcal Biofilm Formation on Marlex Mesh.Arthroplasty today · 2026Article
- Therapeutic Strategies and Clinical Outcomes of Infections Following Anterior Cruciate Ligament Reconstruction: A Narrative Review.Orthopaedic surgery · 2026Review
- Continuous Bone-Quadriceps Tendon-Rectus Femoris Autograft for Revision Anterior Cruciate Ligament and Anterolateral Ligament Reconstructions.Arthroscopy techniques · 2025Article
- Vancomycin-soaking of the graft significantly reduces the incidence of septic arthritis following anterior cruciate ligament reconstruction: comparison of cohorts from the Single-Centre database.International orthopaedics · 2025Article
- Similar results with quadrupled semitendinosus and semitendinosus-gracilis graft in anterior cruciate ligament reconstruction: A randomised controlled trial with 2-year follow-up.Journal of experimental orthopaedics · 2025Article
- Combined Anterior Cruciate Ligament and Lateral Collateral Ligament Reconstruction.Arthroscopy techniques · 2025Article
- Septic Arthritis After Anterior Cruciate Ligament Reconstruction: A Comparative Study of Pediatric, Adolescent, and Young Adult Populations.Orthopaedic journal of sports medicine · 2025Article
- Optimizing Vancomycin Soaking Protocols for Anterior Cruciate Ligament Reconstruction.Antibiotics (Basel, Switzerland) · 2025Article
- Posterior Cruciate Ligament Reconstruction Using a Trans-septal Approach With Preserved Hamstrings Tibial Insertion.Arthroscopy techniques · 2025Article
- Assessing Residual Moisture After Sterilization as an Overlooked Source of Intraoperative Bacterial Contamination in Knee Intra-articular Reconstructions: Evaluating the Reliability of Routine Procedures and Tests.Orthopaedic journal of sports medicine · 2025Article
- Local vancomycin administration in Orthopaedic Surgery - A systematic review of comparative studies.Journal of orthopaedics · 2024Review
- Medial Patellofemoral Ligament Reconstruction Using Gracilis Tendon Graft and "All Suture" Knotless Anchors for Patellar Fixation.Arthroscopy techniques · 2023Article
- Semitendinosus tendons are commonly contaminated with skin flora during graft harvest for anterior cruciate ligament reconstruction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- A Systematic Review and Meta-analysis of Risk Factors for an Infection After Anterior Cruciate Ligament Reconstruction.Orthopaedic journal of sports medicine · 2023Review
- Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction With Pedicular Hamstrings Tendon Graft, Single-Strand Gracilis for ALL and Single Blind Femoral Tunnel.Arthroscopy techniques · 2023Article
- Approaches to Septic Arthritis of the Knee Post Anterior Cruciate Ligament Reconstruction.Current reviews in musculoskeletal medicine · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPresoaking anterior cruciate ligament (ACL) grafts in vancomycin has been reported to reduce the occurrence of septic arthritis (SA). However, strong recommendations for its universal use have been precluded by concerns regarding the fragility of previous meta-analyses. PURPOSE: The primary objective was to investigate whether presoaking ACL grafts in vancomycin was associated with a reduction in the rate of SA in a large series of patients. The secondary objective was to perform an updated systematic review and meta-analysis to determine the efficacy of vancomycin in reducing the rate of SA. STUDY
designCohort study and systematic review; Level of evidence, 3.
methodsA retrospective analysis of patients who underwent primary ACL reconstruction (ACLR) at our institution was undertaken. Rates of postoperative SA were determined and analyzed according to whether patients had received grafts presoaked in vancomycin. A systematic review of the literature and meta-analysis was performed. Odds ratios (ORs) for the risk of SA were calculated according to the inverse variance approach. Results were presented using forest plots, funnel plots, and the fragility index.
resultsA total of 5300 patients underwent primary ACLR during the study period. The rate of SA was 0.34% (11/3228) in the control group and 0.05% (1/2072) in the presoaked group. There was a 5-fold greater risk of SA in patients who did not receive grafts presoaked in vancomycin (OR, 5.13 [95% CI, 1.16-48.30];
conclusionThe meta-analysis demonstrated that presoaking ACL grafts in vancomycin was associated with significant reductions in the rates of SA when all graft types were analyzed together. This finding held true specifically for hamstring tendon autografts. The fragility index of these findings allows for a strong recommendation for the universal use of vancomycin presoaking. However, it should be noted that only a trend toward reduced SA rates was demonstrated with presoaking bone-patellar tendon-bone autografts in vancomycin.
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Registered trials
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.