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Chlorhexidine and chondrolysis in the knee
A L van Huyssteen1, D J Bracey
1Department of Trauma and Orthopaedic Surgery, Treliske Hospital, Truro, England.
The Journal of Bone and Joint Surgery. British Volume
|January 1, 2000
Summary
Dilute chlorhexidine irrigation solutions can cause severe permanent knee damage by damaging articular cartilage. Always verify irrigation solution composition for anterior cruciate ligament reconstruction to prevent chondrolysis.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Histopathology
Background:
- Arthroscopically-assisted anterior cruciate ligament reconstruction is a common orthopedic procedure.
- Irrigation solutions are critical for maintaining joint health during surgery.
- Previous literature has not extensively detailed the effects of chlorhexidine irrigation on articular cartilage.
Purpose of the Study:
- To summarize the clinical and pathological changes in knees following anterior cruciate ligament reconstruction using chlorhexidine irrigation.
- To highlight the potential chondrolytic effects of dilute chlorhexidine solutions on articular cartilage.
Main Methods:
- Case series summarizing clinical observations and pathological findings.
- Analysis of three patients who underwent anterior cruciate ligament reconstruction with 0.02% aqueous chlorhexidine irrigation.
- Histopathological examination of knee joint tissues.
Main Results:
- Patients exhibited marked chondrolysis of articular cartilage.
- Histopathological analysis confirmed severe, permanent damage to the knee joint.
- The observed damage was attributed to the 0.02% chlorhexidine irrigation solution.
Conclusions:
- Even dilute chlorhexidine solutions can cause significant chondrolysis and permanent knee damage.
- Careful verification of irrigation solution composition is essential for arthroscopic procedures.
- Exposure of articular cartilage to chlorhexidine should be strictly avoided in orthopedic surgery.