Vancomycin Wrap for Anterior Cruciate Ligament Surgery: Molecular Insights
| Autor: | Iain B. McInnes, Simon J. Spencer, Brian P. Rooney, Moeed Akbar, C.R. Walker, Michael Mullen, Neal L. Millar, Katy McCall, Caroline Atherton, W. J. Leach, Emma Garcia-Melchor |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Anterior cruciate ligament reconstruction Anterior cruciate ligament medicine.medical_treatment vancomycin Apoptosis Physical Therapy Sports Therapy and Rehabilitation Transplantation Autologous Tissue Culture Techniques 03 medical and health sciences 0302 clinical medicine medicine Humans Knee Orthopedics and Sports Medicine vancomycin wrap 030222 orthopedics Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries ACL Hamstring Tendons anterior cruciate ligament Articles 030229 sport sciences Surgery medicine.anatomical_structure inflammation Vancomycin business Hamstring medicine.drug |
| Zdroj: | The American Journal of Sports Medicine |
| ISSN: | 1552-3365 0363-5465 |
| Popis: | Background: The use of the vancomycin wrap to pretreat the hamstring graft in anterior cruciate ligament reconstruction (ACLR) has grown in popularity since it was first described in 2012 and has significantly reduced rates of postoperative infection. However, it remains unknown if this antibiotic treatment affects the molecular composition of the graft. Purpose: To establish whether treatment with vancomycin at 5 mg/mL, the most commonly used concentration, alters the molecular function of the hamstring graft in ACLR. Study Design: Controlled laboratory study. Methods: Surplus hamstring tendon collected after routine ACLR surgery was used for in vitro cell culture and ex vivo tissue experiments. Vancomycin was used at 5 mg/mL in RPMI or saline diluent to treat cells and tendon tissue, respectively, with diluent control conditions. Cell viability at 30, 60, and 120 minutes was assessed via colorimetric viability assay. Tendon cells treated with control and experimental conditions for 1 hour was evaluated using semiquantitative reverse transcription analysis, immunohistochemistry staining, and protein quantitation via enzyme-linked immunosorbent assay for changes in apoptotic, matrix, and inflammatory gene and protein expression. Results: Vancomycin treatment at 5 mg/mL significantly reduced tenocyte viability in vitro after 60 minutes of treatment ( P < .05); however, this was not sustained at 120 minutes. Vancomycin-treated tendon tissue showed no significant increase in apoptotic gene expression, or apoptotic protein levels in tissue or supernatant, ex vivo. Vancomycin was associated with a reduction in inflammatory proteins from treated tendon supernatants (IL-6; P < .05). Conclusion: Vancomycin did not significantly alter the molecular structure of the hamstring graft. Reductions in matrix protein and inflammatory cytokine release point to a potential beneficial effect of vancomycin in generating a homeostatic environment. Clinical Relevance: Vancomycin ACL wrap does not alter the molecular structure of the ACL hamstring graft and may improve graft integrity. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|