Efficacy of common surgical compounds in preventing articular chondrocyte death from desiccation

Purpose of this study was to identify potential substances that prevent desiccation of chondrocytes.

Macroscopically normal bovine cartilage explants (n = 80) were exposed to room air, or covered with surgical lubricant, Lactated ringer (LR) or Seprafilm (Genzyme Biosurgery, Cambridge, MA) for 0, 30, 60 or 120 min. The viability of superficial chondrocytes was measured after 48 h of incubation in tissue culture media at 37 °C by Live/Dead staining. Chondrotoxicity was measured as the extent of cell death below the articular surface. Statistical analysis was performed with a two-way analysis of variance on the data set and a subsequent Tukey's post hoc test.

Chondrocyte death correlated positively with the length of exposure, regardless of the treatment (p < 0.0001). The extent of superficial chondrocyte death was minimally lower in the LR (89.1 ± 2.6 %, 80.8 ± 1.2 %) and surgical lube (84.3 ± 1.8 %, 75.9 ± 2.7 %) groups than the control (82 ± 5.7 %, 65.6 ± 13.3 %) and Seprafilm group (77.6 ± 3.9 %, 63.3 ± 6.9 %) (p < 0.001) at the first two time points, with no significant difference between the latter groups. After 60 and 120 min, surgical lube resulted in less chondrocyte death than all other groups (70.4 ± 6.8 % and 60.9 ± 5.9 %, all p < 0.0001).

The data suggest that depending on the expected length of exposure of the articular cartilage surface, different compounds appear to be protective. For exposures exceeding 60 min, surgical lubricant demonstrated the highest protective potential. Results from this study indicate that protecting exposed articular surfaces with surgical lubricant for orthopaedic procedures lasting more than 1 h lead to decreased chondrocyte death and suggest improved cartilage functional outcomes postoperatively.