Ruelos VCB, Puzzitiello RN, Menendez ME, et al. - This study sought to ascertain if intraoperative graft soaking with vancomycin is a cost-effective measure for preventing infection after arthroscopic anterior cruciate ligament (ACL) reconstruction and provide an adaptable model for providers and institutions to ascertain the cost-effectiveness of this strategy over a range of initial infection rates, infection-related care costs, and vancomycin costs. Researchers ascertained the cost of treating infection for 2 alternative protocols—irrigation and debridement with revision ACL reconstruction or ACL graft retention. A break-even economic analysis was used to develop an equation to ascertain the absolute risk reduction (ARR) in infection rate required for the use of vancomycin graft soaking to be deemed cost-effective. The data illustrate that in arthroscopic ACL reconstruction, the use of intraoperative graft preparation with vancomycin is a highly cost-effective prophylactic measure for infection prevention.