Ad. Reading et al., Quantitative assessment of the effect of 0.05% chlorhexidine on rat articular cartilage metabolism in vitro and in vivo, J ORTHOP R, 18(5), 2000, pp. 762-767
Wound infection remains a problem. Syringe and needle jet lavage of chlorhe
xidine gluconate 0.05% removed or killed 99.8% of contaminating bacteria wi
thin 1 minute in a wound model. In clinical use, however, possible toxicity
to articular cartilage is a concern. In an established intact rat patella
model bl vitro, 1 minute of exposure to chlorhexidine 0.05% and chlorhexidi
ne jet lavage did not significantly alter cartilage metabolism. A 1-hour ex
posure decreased metabolic activity. In vivo, a 30-minute exposure with or
without rinsing produced no impairment of metabolic activity 6 weeks later,
suggesting that cartilage has the potential for biological recovery. Howev
er, injecting and leaving chlorhexidine 0.05% in the joints was detrimental
to the metabolic activity of the articular cartilage as assessed 6 weeks l
ater. Thus, chlorhexidine gluconate 0.05% could be used on normal articular
cartilage. Any potential damage from prolonged exposure can be avoided by
rinsing after 1 minute.