Does Combined Treatment with Tranexamic Acid and Vancomycin Affect Human Chondrocytes In Vitro?

Area of Science:

• Biomedical Engineering
• Cell Biology
• Orthopedic Surgery

Background:

• Tranexamic acid (TXA) and vancomycin powder (VP) are used in total knee arthroplasty (TKA) to reduce blood loss and infection.
• Potential cytotoxic effects of TXA and VP on periarticular cells, including chondrocytes, require further investigation.

Purpose of the Study:

• To evaluate the combined in vitro effects of TXA and VP on human chondrocytes.
• To determine the impact of varying concentrations and exposure times on chondrocyte viability, proliferation, and gene expression.

Main Methods:

• Human chondrocytes were cultured and exposed to TXA and VP.
• Cell viability and proliferation were assessed using ATP and Annexin 5 assays.
• Chondrogenic marker gene expression was analyzed via semiquantitative RT-PCR.

Main Results:

• Prolonged exposure (>48 hours) of chondrocytes to TXA and VP reduced cell viability and proliferation.
• Effects were observed even at the lowest tested concentrations (TXA 10 mg/mL, VP 3 mg/mL) after 96 hours.
• No significant impact on chondrogenic marker gene expression was detected.

Conclusions:

• Limiting in vitro chondrocyte exposure to TXA and VP to 24 hours appears safe.
• Further research is needed to understand the effects of TXA and VP on other periarticular cells (osteocytes, tenocytes) in TKA.