Department of Orthopaedic Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA.
Medical University of South Carolina, Charleston, SC.
J Orthop Trauma. 2018 Mar;32(3):148-153. doi: 10.1097/BOT.0000000000001040.
To characterize the in vitro toxicity of vancomycin on articular cartilage.
Osteochondral samples extracted from fresh, juvenile porcine stifle (knee) joints were exposed to vancomycin saline concentrations of 2, 5, and 10 mg/mL and compared with a saline and nonsaline treated control. Comparison of chondrocyte viability was assessed with histology examination of chondrocyte degeneration using the Mankin criteria and a live/dead staining using ethidium homodimer-2 and calcien acetoxymethylester stain and confocal laser scanning microscopy.
A comparison of chondrocyte viability in the control sample and 2 mg/mL group showed no statistical difference (P = 0.38). The chondrocyte toxicity was statistically significantly higher in both the 5 mg/mL (P = 0.003) and 10 mg/mL (P < 0.001) experimental groups in comparison to the control sample. Chondrocyte death increased in a statistically significant dose-dependent fashion. Histologically, the Mankin scores were higher for the saline-treated group in comparison to the untreated control group.
Vancomycin is toxic to articular chondrocytes in concentrations of 5 mg/mL and greater. Strategies for controlling concentration must be developed before routine application of topical antibiotics around synovial joints is performed.
研究万古霉素对关节软骨的体外毒性作用。
从新鲜的幼年猪膝关节中提取骨软骨样本,将其暴露于浓度为 2、5 和 10mg/mL 的万古霉素生理盐水中,并与生理盐水和未经生理盐水处理的对照组进行比较。采用 Mankin 标准评估软骨细胞退变的组织学检查、使用 ethidium homodimer-2 和 calcien acetoxymethylester 染色和共聚焦激光扫描显微镜评估软骨细胞活力。
对照组和 2mg/mL 组的软骨细胞活力比较无统计学差异(P=0.38)。与对照组相比,5mg/mL(P=0.003)和 10mg/mL(P<0.001)实验组的软骨细胞毒性均具有统计学意义。软骨细胞死亡呈统计学显著的剂量依赖性增加。组织学上,与未处理的对照组相比,经生理盐水处理的组的 Mankin 评分更高。
万古霉素在 5mg/mL 及以上浓度时对关节软骨细胞有毒性。在关节周围常规应用局部抗生素之前,必须制定控制浓度的策略。