Background:Chlorhexidine gluconate (CHG) solution is commonly used as an antiseptic irrigation for bacterial decontamination during orthopaedic surgery. Although the chondrotoxicity of CHG on articular cartilage has been reported, the full extent of CHG-related chondrotoxicity and its effects on the extracellular matrix and mechanical properties are unknown.Purpose:To investigate the in vitro effects of a single 1-minute CHG exposure on the viability, biochemical content, and mechanics of native articular cartilage explants.Study Design:Controlled laboratory study.Methods:Articular cartilage explants (6 per group) were harvested from femoral condyles of the porcine stifle and sectioned at tidemark. Explants were bathed in CHG solution (0.05% CHG in sterile water) at varying concentrations (0% control, 0.01% CHG, and 0.05% CHG) for 1 minute, followed by complete phosphate-buffered saline wash and culture in chondrogenic medium. At 7 days after CHG exposure, cell viability, matrix content (collagen and glycosaminoglycan [GAG]), and compressive mechanical properties (creep indentation testing) were assessed.Results:One-minute CHG exposure was chondrotoxic to explants, with both 0.05% CHG (2.6% ± 4.1%) and 0.01% CHG (76.3% ± 8.6%) causing a decrease in chondrocyte viability compared with controls (97.5% ± 0.6%; P < .001 for both). CHG exposure at either concentration had no significant effect on collagen content, while 0.05% CHG exposure led to a significant decrease in mean GAG per wet weight compared with the control group (2.6% ± 1.7% vs 5.2% ± 1.9%; P = .029). There was a corresponding weakening of mechanical properties in explants treated with 0.05% CHG compared with controls, with decreases in mean aggregate modulus (177.8 ± 90.1 kPa vs 280.8 ± 19.8 kPa; P < .029) and shear modulus (102.6 ± 56.5 kPa vs 167.9 ± 16.2 kPa; P < .020).Conclusion:One-minute exposure to CHG for articular cartilage explants led to dose-dependent decreases in chondrocyte viability, GAG content, and compressive mechanical properties. This raises concern for the risk of mechanical failure of the cartilage tissue after CHG exposure.Clinical Relevance:Clinicians should be judicious regarding the use of CHG irrigation at these concentrations in the presence of native articular cartilage.

中文翻译：

---

氯己定对关节软骨活力、基质和力学的有害影响

背景：葡萄糖酸氯己定（CHG）溶液通常用作骨科手术期间细菌净化的防腐冲洗剂。尽管CHG对关节软骨的软骨毒性已有报道，但CHG相关软骨毒性的全部范围及其对细胞外基质和机械性能的影响尚不清楚。 目的：研究单次1分钟CHG暴露对关节软骨的体外影响研究设计：对照实验室研究。方法：从猪膝关节股骨髁处收获关节软骨外植体（每组 6 个）并在潮汐线处切片。将外植体在不同浓度（0%对照、0.01%CHG和0.05%CHG）的CHG溶液（无菌水中的0.05%CHG）中浸泡1分钟，然后进行完全磷酸盐缓冲盐水洗涤并在软骨形成培养基中培养。CHG 暴露后 7 天，评估细胞活力、基质含量（胶原蛋白和糖胺聚糖 [GAG]）和压缩机械性能（蠕变压痕测试）。结果：一分钟的 CHG 暴露对外植体具有软骨毒性，0.05% CHG 均具有软骨毒性。 (2.6% ± 4.1%) 和 0.01% CHG (76.3% ± 8.6%) 导致软骨细胞活力与对照组相比下降（97.5% ± 0.6%；两者 P < .001）。任一浓度的 CHG 暴露对胶原蛋白含量均无显着影响，而 0.05% CHG 暴露导致湿重平均 GAG 与对照组相比显着下降（2.6% ± 1.7% vs 5.2% ± 1.9%；P = . 029）。与对照相比，用 0.05% CHG 处理的外植体的机械性能相应减弱，平均聚集模量（177.8 ± 90.1 kPa vs 280.8 ± 19.8 kPa；P < .029）和剪切模量（102.6 ± 56.5 kPa vs 167.9 ± 16.2 kPa；P < .020）。结论：关节软骨外植体暴露于 CHG 一分钟会导致软骨细胞活力、GAG 含量和压缩机械性能呈剂量依赖性下降。这引起了人们对 CHG 暴露后软骨组织机械故障风险的担忧。临床相关性：在存在天然关节软骨的情况下，临床医生应明智地使用这些浓度的 CHG 冲洗。