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Vancomycin is toxic to human chondrocytes in vitro

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Vancomycin powder (VP) is a well-established topical antibiotic used in spinal surgery to prevent surgical site infections. More recently its extension to hip and knee arthroplasty was introduced. The aim of this study was to examine toxic effects of VP on the viability of human chondrocytes. Our hypothesis was that VP damages human chondrocytes in vitro with increasing concentration and length of exposure.

Material and methods

Primary human chondrocytes were isolated and cultured from donated human knee joints. VP was added to these cultures with increasing concentrations (0–50 mg/ml) and length of exposure (0–336 h). Toxicity and viability were analyzed using LDH und XTT Elisa assays. Cell structure and determination of vital versus dead cells were visualized using light microscopy and fluorescence microscopy.

Results

Light microscopy and fluorescence microscopy visualized defect cell structures and cell death proportional to increasing dose and length of exposure to VP. The analysis of LDH activity data showed toxic effects on chondrocytes as early as 2,5 min after exposure to VP. XTT activity data revealed a significant toxic threshold of a VP concentration above 12.5 mg/ml.

Conclusions

These results show that exposure to high VP concentrations yields to a damage of human chondrocytes in vitro. Chondrotoxicity is an immediate effect that is proportional to VP concentration. Therefore, the intraarticular use of high concentrations of vancomycin powder in the presence of native cartilage tissue must be considered critically.

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Acknowledgements

We would like to thank Mrs. B. Ukena for her assistance and collaboration.

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Authors and Affiliations

  1. Department of Orthopedics, Jena University Hospital, Campus Eisenberg, Klosterlausnitzer Straße 81, 07607, Eisenberg, Germany

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

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  1. Eric Röhner
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  2. Timo Zippelius
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  3. Sabrina Böhle
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  4. Sebastion Rohe
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  5. Georg Matziolis
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Correspondence to Eric Röhner.

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Röhner, E., Zippelius, T., Böhle, S. et al. Vancomycin is toxic to human chondrocytes in vitro. Arch Orthop Trauma Surg 141, 375–381 (2021). https://doi.org/10.1007/s00402-020-03431-5

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  • DOI: https://doi.org/10.1007/s00402-020-03431-5

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