Introduction: During anterior cruciate ligament (ACL) reconstruction, intraoperative
graft contamination or postoperative infection remains a notable clinical concern.
While antiseptic solutions are increasingly employed for graft decontamination and
infection prophylaxis, the potential impact of these agents on the biomechanical integrity
of tendon grafts has not been fully elucidated. This experimental study aimed to evaluate
the biomechanical effects of soaking tendon grafts in vancomycin, chlorhexidine, and
povidone-iodine solutions.
Methods: Fresh bovine deep digital flexor tendons were used to simulate ACL autografts
and randomly assigned to four groups (n = 6): 4% chlorhexidine, 10% povidone-iodine,
5 mg/mL vancomycin, and 0.9% isotonic saline (control). After 30-minute soaking, tendons
were sutured using a Four Rip-Stop technique and biomechanically tested using a servohydraulic
tensile system. Failure load, stiffness, and cyclic elongation were measured. Statistical
analysis was performed using Kruskal-Wallis and Mann-Whitney U tests with Bonferroni
correction.
Results: Vancomycin and chlorhexidine groups exhibited significantly lower cyclic
elongation compared to control and povidone-iodine groups. Failure load was also significantly
higher in these groups, particularly compared to povidone-iodine, which demonstrated
the weakest biomechanical performance. No significant differences in stiffness were
observed across groups.
Conclusion: Vancomycin and chlorhexidine can be safely used for short-term antiseptic
soaking without compromising graft mechanical integrity. In contrast, povidone-iodine
may weaken tendon structure. These findings may guide antiseptic use during ACL reconstruction
and in managing contaminated tendons in open injuries.
