Vancomycin is toxic to human chondrocytes in vitro

Röhner, Eric; Zippelius, Timo; Böhle, Sabrina; Rohe, Sebastion; Matziolis, Georg; Jacob, Benjamin

doi:10.1007/s00402-020-03431-5

Cited by 13 publications

(23 citation statements)

References 24 publications

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“…A handful of studies have examined vancomycin toxicity to chondrocytes, tenocytes, and other cells involved in tissue regeneration. Roher et al observed chondrocyte necrosis in vitro at VP concentrations of approximately 6.125 mg/mL 54 . Shaw et al exposed porcine knee joints to various concentrations of vancomycin and examined the chondrocyte viability, discovering that chondrocyte toxicity occurred in concentrations of 5 mg/mL and greater 55 .…”

Section: Discussionmentioning

confidence: 99%

“…A handful of studies have examined vancomycin toxicity to chondrocytes, tenocytes, and other cells involved in tissue regeneration. Roher et al observed chondrocyte necrosis in vitro at VP concentrations of approximately 6.125 mg/mL 54 57 . Less than one quarter of osteoblasts and myoblasts survived at all concentrations of vancomycin in the group exposed for 48 hours 57 .…”

Section: Discussionmentioning

confidence: 99%

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Local Application of Vancomycin in Orthopaedic Surgery—A Review

Nelson

Maez

Kump

et al. 2022

JBJS Journal of Orthopaedics for Physician Assistants

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The aim of this review was to report on the use of local application of vancomycin in various realms of orthopaedic surgery, discuss limitations on current studies, and identify potential areas for future research. Vancomycin powder has been used effectively and extensively to prevent surgical site infection in spine surgery, leading to an increased use in other orthopaedic subspecialties. Vancomycin soaking is an emerging technique used in anterior cruciate ligament reconstruction to presoak grafts before implantation. The potential effect to surrounding structures that result from using high localized concentrations of vancomycin is an area of the literature that may be beneficial to further understand. Given the increasing use of locally applied vancomycin, it is essential to understand the spectrum of benefits and safety and continue to analyze the results of emerging studies to guide the future safe practice of surgeons. It is also important to consider population-level effects, such as antimicrobial resistance, that may be associated with more frequent use of vancomycin. Our review concluded that the current literature is limited to mainly retrospective or observational studies, and it would be beneficial to conduct more randomized control trials and prospective studies.

show abstract

Section: Discussionmentioning

confidence: 99%

“…A handful of studies have examined vancomycin toxicity to chondrocytes, tenocytes, and other cells involved in tissue regeneration. Roher et al observed chondrocyte necrosis in vitro at VP concentrations of approximately 6.125 mg/mL 54 57 . Less than one quarter of osteoblasts and myoblasts survived at all concentrations of vancomycin in the group exposed for 48 hours 57 .…”

Section: Discussionmentioning

confidence: 99%

Local Application of Vancomycin in Orthopaedic Surgery—A Review

Nelson

Maez

Kump

et al. 2022

JBJS Journal of Orthopaedics for Physician Assistants

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show abstract

“…This reflects the many years’ clinical practice and proven efficacy of intraarticular injection of the substances tested. However cytotoxicity of vancomycin, tranexamic acid and local anesthetics could be demonstrated by several studies and combination therapy would be very likely to increase local cytotoxic effects 31 – 33 .…”

Section: Discussionmentioning

confidence: 99%

The bactericidal effect of vancomycin is not altered by tranexamic acid, adrenalin, dexamethasone, or lidocaine in vitro

Schwerdt¹,

Röhner²,

Böhle³

et al. 2021

Sci Rep

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One of the most challenging complications of total knee arthroplasty (TKA) is periprosthetic joint infection (PJI). There is growing evidence of a good anti-infective effect of intrawound vancomycin powder in total joint arthroplasty. At the same time, various different locally applied substances have become popular in total joint arthroplasty. The objective of this study was therefore to investigate a possible inhibition of the bactericidal effect of vancomycin by tranexamic acid, adrenalin, lidocaine, or dexamethasone. The bactericidal effect of vancomycin was quantified using the established method of the agar diffusion test. The plates were incubated with Staphylococcus aureus or Staphylococcus epidermidis and four wells were stamped out. The wells were filled with vancomycin alone, the tested substance alone or a mixture of the two. The fourth well remained empty as a control. The plates were incubated overnight at 37 °C and the zone of inhibition in each field was measured on the next day. All tests were run three times for each pathogen and mean values and standard deviations of the measurements were calculated. Differences between the substances were tested using the t-test at a level of significance of 0.05. The bacterial growth was homogeneous on all plates. The baseline value for the zone of inhibition of vancomycin was on average 6.2 ± 0.4 mm for Staphylococcus aureus and 12 ± 0.3 mm for Staphylococcus epidermidis. In all other substances, no inhibition was detected around the well. The combination of vancomycin and each other substance did not show any different result compared to vancomycin alone. The bactericidal effect of vancomycin on staphylococci is not altered by tranexamic acid, adrenalin, dexamethasone, or lidocaine in vitro.

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“…Only vancomycin concentrations above 6.25 mg/mL have been shown to be chondrotoxic. 16 Therefore the concern regarding cartilage damage is unfounded.…”

Section: See Related Article On Page 953mentioning

confidence: 99%

Editorial Commentary: Vancomycin Soaking of the Graft in Anterior Cruciate Ligament Reconstruction: A Concept on the Way to Becoming the New Gold Standard

Pfeiffer

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Vancomycin is toxic to human chondrocytes in vitro

Cited by 13 publications

References 24 publications

Local Application of Vancomycin in Orthopaedic Surgery—A Review

Local Application of Vancomycin in Orthopaedic Surgery—A Review

The bactericidal effect of vancomycin is not altered by tranexamic acid, adrenalin, dexamethasone, or lidocaine in vitro

Editorial Commentary: Vancomycin Soaking of the Graft in Anterior Cruciate Ligament Reconstruction: A Concept on the Way to Becoming the New Gold Standard

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