The Effect of Gentamycin in the Irrigating Solution to Prevent Joint Infection after Anterior Cruciate Ligament (ACL) Reconstruction

Document Type : RESEARCH PAPER

Authors

1 Department of knee Surgery, Bone and Joint Reconstruction Research Center, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran

2 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran

3 Center for Advanced Orthopaedic Studies at BIDMC - Harvard Medical School, Boston, MA, USA

4 Center for Advanced Orthopaedic Studies at Beth Israel Deaconess Medical Center, Harvard Medical School, MA, USA

5 Tufts Medical Center, Boston, USA

Abstract

Background: Arthroscopic reconstruction of ACL is an effective method to restore knee stability after ACL rupture.
Postoperative septic arthritis (SA) is very uncommon while the incidence of serious complications range between
0.14% and 1.8%. Some of the devastating consequences of septic arthritis can encompass hyaline cartilage damage,
arthrofibrosis, and in rare cases amputation. The purpose of this study was to evaluate the effect of gentamicin irrigation
solutions as a process to restrain septic arthritis following arthroscopic ACL reconstruction.
Methods: In this retrospective cohort study, 1464 patients who underwent ACL reconstruction with hamstring tendon
autograft in our institution over 7 years (February 2008 to January 2015) were included. The patients were divided
into two groups based on the type of intra-articular irrigation solution used during the surgery. Patients in Group 1
(Saline) received intra-articular irrigation with normal saline (0.9 % sodium chloride) solution, while those in Group 2
(Gentamycin) received intra-articular irrigation with gentamicin (80 mg/L) added to the normal saline solution. Data
about postoperative infection, its course, management, and outcome were obtained from patients’ records.
Results: Seven patients developed SA, four of whom were from SALINE group (2.2%) and three from Gentamycin
group (0.23%). The incidence rate of SA after arthroscopic ACL reconstruction was significantly lower (P <0.05) when
irrigated with gentamicin solution than merely with saline solution.
Conclusion: Gentamicin irrigation solution has a preservative and protective effect against SA development following
arthroscopic ACL reconstruction. We recommend evaluating this technique as a way in order to depreciate the
prevalence of SA after ACL reconstruction.
Level of evidence: III

Keywords

Main Subjects

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The Archives of Bone and Joint Surgery
Volume 7, Issue 1
January and February 2019
Pages 67-74

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History

  • Receive Date: 03 May 2018
  • Revise Date: 04 October 2018
  • Accept Date: 21 October 2018
  • First Publish Date: 01 January 2019

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