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Abstract

Septic arthritis following anterior cruciate ligament (ACL) repair surgery is an extremely rare but possibly fatal consequence. To mitigate this danger, our team began presoaking grafts with vancomycin. Objectives: To determine the association of septic arthritis following anterior cruciate ligament (ACL) restoration using hamstring autografts with and without grafts presoaked in vancomycin. Methods: This study included 350 patients who had primary hamstring autograft ACL repair. Patients were equally divided into two groups. Group I had a pre-vancomycin protocol among 175 cases, and 175 cases of Group II received the vancomycin protocol. Postoperative septic arthritis was a likely outcome in both groups. Combining clinical findings with cytological examination of joint aspiration (cell count >50,000/μL and >90% neutrophils), a diagnosis of likely septic arthritis was reached. A Fisher's exact test was used for statistical analysis. We fixed the significance level at p<0.05. Results: There were a majority of 240 (68.6%) male and 110 (31.4%) female among all cases. Included cases had a mean age of 27.18 ± 11.58 years and had a mean BMI of 26.12 ± 8.38 kg/m2. Post-operatively, the frequency of septic arthritis was only found in group I among 7 (17.1%) cases, and no cases were found in group II. Among 7 cases of septic arthritis in group I, 4 cases had Staphylococcus epidermidis, and no organisms were isolated in 3 cases. Conclusions: It was concluded that presoaking the grafts in vancomycin for primary ACL repair decreased the likelihood of postoperative septic arthritis compared to not soaking them.