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 1 min. Reports of chondrolysis following exposure to concentrations of > 0.05% or prolonged exposure to chtorhexidine 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 chtorhexidine 0.05% for 1 min and 1 h. The metabolism of non-osteoarthritic cartilage was not significantly affected by a 1 min exposure to chlorhexidine 0.05% whereas that of osteoarthritic cartilage was markedly impaired. Prolonged exposure for 1 h markedly affected both types of cartilage. These results are encouraging in that 0.05% chtorhexidine 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. (c) 2007 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.