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Joint German Congress of Orthopaedics and Trauma Surgery

02. - 06.10.2006, Berlin

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Effect of polyhexanide and gentamycin on human osteoblasts and endothelial cells

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  • A. Ince - Klinik f. Orthopädie, Universität Würzburg, Würzburg, Germany
  • N. Schütze - Klinik f. Orthopädie, Universität Würzburg, Würzburg, Germany
  • J. Eulert - Klinik f. Orthopädie, Universität Würzburg, Würzburg, Germany
  • J. Löhr - Orthopädische Chirurgie, ENDO-Klinik, Hamburg, Germany
  • A. Katzer - Orthopädische Chirurgie, ENDO-Klinik, Hamburg, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 92. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 47. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 02.-06.10.2006. Düsseldorf, Köln: German Medical Science; 2006. DocE.4.1-31

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgu2006/06dgu0105.shtml

Published: September 28, 2006

© 2006 Ince et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

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Introduction: Infection of total joint replacements are painful, disabling and difficult to treat because of the increasing bacterial resistance against antibiotics. In view of this, antiseptics show limited bacterial tolerance and have a broad-spectrum antimicrobial activity. However, the application of antiseptics to bone is insufficiently studied in literature. Therefore, we investigated the biocompatibility of the antiseptic polyhexanide with bone related cells and asked whether supplementation to bone cement is appropiate in the management of total arthroplasty infections.

Methods: We performed an in vitro study with immortalized human fetal osteoblast cells (hFOB 1.19) and human endothelial cells (EAhy 926). They were exposed to polyhexanide (px) and the results were with gentamicin(g), which is used actually as a supplementation to bone cement in orthopaedic surgery. The cultured cells were exposed to media containing various concentrations of gentamicin (12.5-800µg/ml) and polyhexanide (0.0006-0.01%) for six hours. We measured the phase-contrast microcopy images, the cell viability, cell number and the alkaline phosphatase activity as a parameter for osteogenic function.

Results: The exposure of hFOB and endothelial cells to polyhexanide showed a severe reduction of viability and cell number. Gentamicin did not have negative effects on hFOB and endothelial cell number and viability. The alkaline phosphatase activity of hFOB showed a significant decrease after exposure to polyhexanide and gentamicin. The viability and the cell number of endothelial cells were more negatively affected by polyhexanide than the parameters of the hFOB-cells.

Conclusions: The exposure of human osteoblasts and endothelial cells to polyhexanide at concentrations with questionable antibacterial activity resulted in a severe cell damage whereas exposure to high dosed gentamicin did not. These results raise questions as to the feasibility of using antiseptics in bone cement for the treatment of total arthroplasty infections. Further in vivo studies are necessary to show the in vivo relevance of these in vitro findings.