Efficacy of Irrigation Solutions in Local Adjuvant Therapy following Intralesional Curettage

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Efficacy of Irrigation Solutions in Local Adjuvant Therapy following Intralesional Curettage

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Moore et al. (2022) | DOI: 10.2106/JBJS.22.00404

Cytotoxic Effects of Common Irrigation Solutions on Chondrosarcoma and Giant Cell Tumors of Bone

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Irrigation solutions are often used as cytotoxic adjuvants to reduce the risk of tumor recurrence resulting from cell shedding and seeding following

intralesional curettage of bone tumors

However, it is not clear which solution exhibits the highest cytotoxicity

Cytotoxicity levels

Chondrosarcoma vs

H

2

O 3% H

2

O

2

70% EtOH

0.3% PVP-I

−2.45% −24.06%

−5.00%

5.33%

7.15% 15.11%

18.37% 37.04%

GCT vs

H

2

O

2 min

28.26% 38.22%

Separately, cells were irrigated with test solutions (including high and low control) for 2- and 5-minute intervals

Cells cultured, plated, and incubated

Human giant cell tumor (GCT) cells JJ human chondrosarcoma cell line

Individual cell suspensions plated in well plates at 10,000 cells per well

Normal saline

0.9%

Povidone -iodine

(PVP-I) 0.3%

Chlorhexidine gluconate

(CHG) 0.05%

Ethanol (EtOH)

70%

Hydrogen peroxide

(H₂O₂) 3%

Sterile water (H₂O)

High-Cytoxicity Control: Triton X-100= 100%

cytotoxicity

Low-Cytotoxity Control: growth

media = 0%

cytotoxicity

A B

G H E F C D

1 2 3 4 5 6 7 8 9 10 11 12

Assessment of cytotoxicity using lactate dehydrogenase assays

2 min 5 min 5 min

Owing to its higher cytotoxic efficacy, easy availability, and safety of use, 0.05% CHG (chlorhexidine gluconate) solution could be a potential chemical

Efficacy of Irrigation Solutions in Local Adjuvant Therapy following Intralesional Curettage