Editorial Commentary: Is It Time for the Vancomycin Wrap to Become a Universal Recommendation for the Prevention of Septic Arthritis Following Anterior Cruciate Ligament Reconstruction?
| Autor: | Christopher J. Vertullo |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Anterior cruciate ligament reconstruction Anterior cruciate ligament medicine.medical_treatment Arthritis law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Vancomycin law Humans Medicine Infection control Orthopedics and Sports Medicine Anterior Cruciate Ligament Intensive care medicine Arthritis Infectious 030222 orthopedics Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries 030229 sport sciences medicine.disease Anti-Bacterial Agents medicine.anatomical_structure Septic arthritis Observational study business medicine.drug |
| Zdroj: | Arthroscopy: The Journal of Arthroscopic & Related Surgery. 37:1691-1693 |
| ISSN: | 0749-8063 |
| DOI: | 10.1016/j.arthro.2021.02.002 |
| Popis: | Septic arthritis is a devastating complication of anterior cruciate ligament (ACL) reconstruction, which can still occur in approximately 1% of patients despite appropriate intravenous antibiotic prophylaxis and other recommended preventative measures being undertaken. The infection is most likely secondary to the autograft becoming contaminated during harvest and preparation, introducing bacteria into the joint on insertion. Presoaking ACL grafts in 5 mg/mL vancomycin is a novel method developed to eradicate this bacterial contamination and is supported by compelling Level III evidence from multiple observational trials showing a dramatic reduction in infection rates without any evidence of increased graft failure. As such, it is time for this technique to become a universal recommendation? That said, as observational studies using a historical cohort as a comparator are at risk of various biases, Level I evidence is ultimately required for infection prophylaxis methods to be recognized as a universal recommendation in infection control guidelines. Consequently, future research endeavors on the "vancomycin wrap" should focus on randomized controlled trials, possibly nested within ACL registries. |
| Databáze: | OpenAIRE |
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