The role of vancomycin-soaking of the graft in anterior cruciate ligament reconstruction

E. Carlos Rodriguez-Merchan*, Bill Ribbans

*Corresponding author for this work

Research output: Contribution to JournalArticlepeer-review


Approximately 1% of anterior cruciate ligament reconstruction (ACLR) procedures develop septic arthritis despite intravenous antibiotic prophylaxis and other preventive measures. Infection is most commonly due to contamination during autograft harvest and preparation by introducing bacteria into the knee during graft insertion. Pre-soaking ACL grafts in 5 mg/mL vancomycin ("vancomycin wrap") has been utilised to eradicate such bacterial contamination. Many level III studies have reported a marked decrease in infection rates with no increase in graft failure rates. However, the lack of prospective randomised control trials and these studies' heterogeneity do not allow a universal recommendation for vancomycin pre-soaking of all grafts during ACLR. Randomised controlled trials are needed to confirm efficacy in reducing sepsis rates. [Abstract copyright: Crown Copyright © 2022. Published by Elsevier Inc. All rights reserved.]
Original languageEnglish
Pages (from-to)94-98
Number of pages5
JournalJournal of ISAKOS
Issue number2
Early online date7 Jan 2022
Publication statusPublished - 1 Apr 2022


  • Knee surgery
  • Anterior Cruciate Ligament
  • Sports Injuries
  • Antibiotics
  • Infection
  • Reconstruction
  • Post-operative infection
  • Autografts
  • Anterior Cruciate Ligament Reconstruction - methods
  • Humans
  • Pre-soaking ACL grafts
  • Anti-Bacterial Agents - pharmacology - therapeutic use
  • Anterior cruciate ligament
  • Anterior Cruciate Ligament Injuries - surgery
  • Vancomycin - therapeutic use
  • Graft


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