Toxicity of antiseptics against chondrocytes: What is best for the cartilage in septic joint surgery?

Abstract

In septic joint surgery, the most frequently used antiseptics are polyhexanide, hydrogen peroxide and taurolidine. The aim of this study was to examine the effects of these antiseptics on viability of human chondrocytes. Our hypothesis was that antiseptics and supplemental irrigation with sodium chloride lavage are less toxic on human chondrocytes than treatment with antiseptics only. Primary human chondrocytes were isolated and cultured from six donated human knee joints. Polyhexanide, hydrogen peroxide or taurolidine were added to the cultures. Toxicity analysis was performed by visualisation of cell structure using light microscopy and LDH activity. The determination of vital cells and total cell numbers of chondrocytes treated with antiseptics partly followed by irrigation with sodium chloride solution was performed by using Casy Cell-Counter. Light microscopic data revealed a defect in cell structure after addition of antiseptics. We showed a significant increase of LDH enzyme activity after the treatment with polyhexanide or taurolidine. After treatment with antiseptics followed by sodium chloride solution a significant increase of vital and total cell numbers resulted in comparison with the chondrocytes that were only treated with antiseptics. The data show that treatment with polyhexanid, hydrogen peroxide or taurolidine induces cell death of human chondroctes in vitro. The application of sodium chloride solution after the treatment with polyhexanide and hydrogen peroxide possibly has a protective effect on chondrocyte viability.

Efficacy of taurolidine against periodontopathic species—an in vitro study

“…The systemic toxicity of taurolidine appears to be low indicated by the finding that healthy volunteers were administered 5 g of taurolidine per day without serious adverse effects [8]. In vitro, toxic effects were observed after 30 min exposure of 0.5% taurolidine to chondrocytes but still being less in comparison to 3% hydrogen peroxide and 0.04% polyhexanide [9].…”

Osteoarthritis synovial fluid activates pro-inflammatory cytokines in primary human chondrocytes

“…Chondrocyte isolation was performed as described previously [11]. Cartilage tissue was minced and digested in medium containing 1 mg/ml pronase (Sigma-Aldrich, Deisenhofen, Germany) for 30 minutes at 37°C.…”

Human osteoblast damage after antiseptic treatment

“…Literature reviews have revealed very limited data about the effects of polyhexanide exposure to human osteoblasts. In previous studies, we were able to show a superiority of polyhexanide compared with other antiseptics in treating human chondrocytes [11][12][13]. Polyhexanide has a late antiseptic onset of five to 20 minutes and therefore requires prolonged exposure time [14].…”