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In Vitro Study of Gentamicin Elution from Tendon Grafts

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Abstract

Background

Though vancomycin-soaked graft reduces the infection rate after ACL reconstruction, concerns exist regarding this usage. Gentamicin has been used for graft soakage with satisfactory clinical results but gentamicin’s elution characteristics are unknown.

Methods

Thirty Bovine tendon grafts were harvested from ten limbs under sterile conditions. Three tendons from each of the limbs were allotted into three groups and soaked in either saline, gentamicin or vancomycin. Pre-soakage and post-soakage swabs were cultured. Soaked grafts were immersed in a 10 ml saline solution for 5 min (initial washout) and then in another 10 ml saline solution (sustained release) for 10 min. No 1 Whatman filter paper was immersed in the solutions and placed on culture plates streaked with coagulase-negative Staphylococcus aureus (CONS) and methicillin-resistant Staphylococcus aureus (MRSA), and inhibition was noted. The difference between the two proportions was assessed by two proportion t-test for p < 0.05.

Results

No organism was cultured in the pre-soakage or post-soakage swab in any specimen. Specimens from one limb were excluded since saline-soakage showed inhibition. Elution from gentamicin-soaked graft inhibited CONS in eight out of nine samples in initial washout and all samples in sustained release solution but inhibited MRSA only in one sample in sustained release solution and the initial washout solution. Vancomycin elution inhibited both organisms in all samples.

Conclusions

Gentamicin elution from tendon graft achieves minimal inhibitory concentration against susceptible organisms. Though its clinical utility is restricted by limited antimicrobial spectrum, and it could be used where the risk of contamination by MRSA is low.

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Data Availability

Not applicable.

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Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Dhanalakshmi Srinivasan Medical College, Perambalur, 620021, India

    I. Geethan, M. HarriVishnu & A. Subashankar

  2. Department of Microbiology, Dhanalakshmi Srinivasan Medical College, Perambalur, India

    V. Sindhanai

  3. Apollo Hospitals, Chennai, India

    M. KanniRaj

  4. 20-A, Mahalakshmi Nagar, K K Nagar Post, Trichy, 620021, India

    I. Geethan

  5. Knee and Shoulder Surgery, Arthroscopy Centre Trichy, Tiruchirappalli, India

    I. Geethan

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  1. I. Geethan
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  2. M. HarriVishnu
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  3. V. Sindhanai
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  4. A. Subashankar
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  5. M. KanniRaj
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Contributions

IG conceptualized the study, performed the sampling portion of the experiment and wrote the manuscript. MH assisted the sampling portion of the experiment and managed the logistics of the experiment, VS performed analytical portion of the experiment, ASS assisted in the sampling portion of the experiment, MK assisted in the manuscript preparation. All authors read and approved the final manuscript.

Corresponding author

Correspondence to I. Geethan.

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Conflict of Interest

On behalf of all authors, the corresponding author states that there is no conflict of interest. The authors declare that they have no competing interests.

Ethical Approval

Institutional animal ethical committee approval was not required as the study did not involve live animals. (email dated 12/05/2022 from Committee for the Purpose of Control And Supervision of Experiments on Animals. Proposal number, IAEC/DSMC/2021PI).

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For this type of study informed consent is not required.

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Geethan, I., HarriVishnu, M., Sindhanai, V. et al. In Vitro Study of Gentamicin Elution from Tendon Grafts. JOIO 57, 1118–1125 (2023). https://doi.org/10.1007/s43465-023-00897-4

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  • DOI: https://doi.org/10.1007/s43465-023-00897-4

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