Schaumburger J, Beckmann J, Springorum H-R, Handel M, Anders S, Kalteis T, Grifka J, Rath B
Klinik und Poliklinik für Orthopädie-Lehrstuhl für Orthopädie der Universität Regensburg, Asklepios Klinikum Bad Abbach GmbH, Bad Abbach.
Z Orthop Unfall. 2010 Jan;148(1):39-43. doi: 10.1055/s-0029-1186127. Epub 2009 Oct 19.
Local antiseptics are commonly used for perioperative skin and wound disinfection and as solutions for joint lavage. Therefore, we examined if an intra-articular use of these antiseptics is possible by using an IN VITRO chondrocyte model.
Articular chondrocytes harvested from 7 patients were cultured. After reaching 80% confluency different concentrations (0%, 1%, 10%, 50%, 100%) of polyhexanide, hydrogen peroxide and povidone-iodine were added for 5 minutes. Afterwards, the solution was removed and the chondrocytes were cultured for 24 hours. Subsequently the vitality and proliferation rate (DNA synthesis) were analysed with the WST-1 and BrdU tests.
1% povidone-iodine and 1% hydrogen peroxide solutions significantly (p=0.001) decreased the chondrocyte vitality as compared to our control group. There was no significant difference (p=0.71) after the application of 1% polyhexanide in the vitality ratios. A significant decrease in vitality was also observed after the application of 10% polyhexanide solution (p=0.001). Application of 1% povidone-iodine solution, 1% hydrogen peroxide solution and 10% polyhexanide revealed a decrease in the metabolic cell activity of 80% compared to our control group, whereas the activity was 65% (p=0.026) compared to the control group after application of 1% polyhexanide solution.
Our results demonstrate the chondrotoxic effect of the tested antiseptic solutions in clinical used concentrations within short time points. Polyhexanide in a low concentrated solution (1%) was the antiseptic with the lowest influence on the vitality and the DNA synthesis of chondrocytes. Thus, this antiseptic solution seemed to be the best choice for intra-articular application. But overall, our study showed general limitations for the intra-articular use of local antiseptics.
局部抗菌剂常用于围手术期皮肤和伤口消毒以及作为关节灌洗溶液。因此，我们通过体外软骨细胞模型研究了这些抗菌剂关节内使用的可能性。
从7名患者获取的关节软骨细胞进行培养。在达到80%汇合度后，加入不同浓度（0%、1%、10%、50%、100%）的聚己双胍、过氧化氢和聚维酮碘5分钟。之后，去除溶液，软骨细胞再培养24小时。随后用WST-1和BrdU试验分析活力和增殖率（DNA合成）。
与我们的对照组相比，1%聚维酮碘溶液和1%过氧化氢溶液显著（p=0.001）降低软骨细胞活力。应用1%聚己双胍后活力比率无显著差异（p=0.71）。应用10%聚己双胍溶液后也观察到活力显著下降（p=0.001）。与对照组相比，应用1%聚维酮碘溶液、1%过氧化氢溶液和10%聚己双胍后代谢细胞活性降低80%，而应用1%聚己双胍溶液后与对照组相比活性为65%（p=0.026）。
我们的结果表明，在临床使用浓度下，测试的抗菌溶液在短时间内具有软骨毒性作用。低浓度溶液（1%）中的聚己双胍是对软骨细胞活力和DNA合成影响最小的抗菌剂。因此，这种抗菌溶液似乎是关节内应用的最佳选择。但总体而言，我们的研究表明局部抗菌剂关节内使用存在普遍局限性。
