Brief exposure of 0.05% chlorhexidine does not impair non-osteoarthritic human cartilage metabolism

Jet lavage with chlorhexidine 0.05% is an effective means of wound decontamination with 99% of bacteria removed or killed after 1min. Reports of chondrolysis following exposure to concentrations of >0.05% or prolonged exposure to chlorhexidine have curtailed its use in orthopaedic practice. Using radiolabelled sulphur uptake to measure cartilage metabolism, we quantitatively assessed the in-vitro effect of osteoarthritic and non-osteoarthritic human cartilage exposure to chlorhexidine 0.05% for 1min and 1h. The metabolism of non-osteoarthritic cartilage was not significantly affected by a 1min exposure to chlorhexidine 0.05% whereas that of osteoarthritic cartilage was markedly impaired. Prolonged exposure for 1h markedly affected both types of cartilage. These results are encouraging in that 0.05% chlorhexidine may have a role in the decontamination of contaminated open joint injuries in patients with no signs of osteoarthritis. Until there is further understanding of the mechanism underlying reported incidents of chondrolysis following its use, however, it cannot be recommended for the irrigation of 'clean' articular cartilage.