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The In Vitro Elution Characteristics of Vancomycin from Tendons

  • Basic Research
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Infection after ACL reconstruction is uncommon but catastrophic. Prophylactic graft saturation in vancomycin reportedly reduces infection rates.

Questions/purposes

We characterized vancomycin elution from soaked tendons. Specifically, the effect of rinsing was studied. We also determined how vancomycin concentration in the soak solution and tendon dimension influenced this elution rate, and examined whether the vancomycin amount released was lower than osteoblast and chondroblast toxic concentrations.

Methods

Bovine tendons were wrapped in sterile gauze swabs presoaked with 5-, 2.5-, or 1.25-mg/mL vancomycin solutions. After 10 minutes, rinsed and unrinsed tendons were placed in 100 mL agitated 37°C phosphate-buffered saline (PBS). One-milliliter samples taken at 10 minutes and 1, 6, 12, 24, and 72 hours were analyzed by high-performance liquid chromatography.

Results

The maximum elution rate occurred between 10 minutes and 1 hour, with no lag between experiment initiation and drug appearance in the solution. Rinsing affected the initial amount in solution but had little influence on drug release after 10 minutes. Vancomycin diffusion rates were dependent on soak solution concentration at all sampling intervals. The vancomycin amount released or eluted did not increase after the 1-hour interval. At 24 hours, concentrations were 45 ± 12, 16 ± 1, and 9 ± 3 μg/mL for the 5-, 2.5-, and 1.25-mg/mL solutions, respectively. Higher elution rates were observed in larger-volume tendons.

Conclusions

Soaked tendon grafts can act as reservoirs for vancomycin, with the amount released and elution profile dependent on rinsing, tendon volume, and soak solution concentration. Vancomycin elution was lower than previously reported osteoblast and chondroblast toxicity concentrations and above the minimum inhibitory concentration for Staphylococcus.

Clinical Relevance

Presoaking ACL reconstruction autografts with vancomycin may reduce the risk of ACL reconstruction infection without the risk of local or general toxicity.

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Authors and Affiliations

  1. School of Physiotherapy and Exercise Science, Griffith University, Gold Coast, 4222, Australia

    Jane E. Grayson PhD

  2. Griffith Health Institute, Griffith University, Gold Coast, Australia

    Gary D. Grant PhD & Shailendra Dukie PhD

  3. The Knee and Sports Medicine Centre, Gold Coast, Australia

    Christopher J. Vertullo MBBS, FRACS

Authors
  1. Jane E. Grayson PhD
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  2. Gary D. Grant PhD
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  3. Shailendra Dukie PhD
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  4. Christopher J. Vertullo MBBS, FRACS
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Corresponding author

Correspondence to Jane E. Grayson PhD.

Additional information

One or more of the authors (GG, SD) have received funding from Griffith Health Institute.

Each author certifies that his or her institution has approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at Griffith University, Gold Coast, Australia.

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Grayson, J.E., Grant, G.D., Dukie, S. et al. The In Vitro Elution Characteristics of Vancomycin from Tendons. Clin Orthop Relat Res 469, 2948–2952 (2011). https://doi.org/10.1007/s11999-011-1768-3

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  • DOI: https://doi.org/10.1007/s11999-011-1768-3

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