Effects of intra-articular chlorhexidine diacetate lavage on the stifle in healthy dogs

Mark A. Anderson From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine (Anderson, Payne, Mann), Department of Veterinary Pathology, Veterinary Medical Diagnostic Laboratory (Kreeger, Schmidt), and Cardiothoracic Surgery Division, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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John T. Payne From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine (Anderson, Payne, Mann), Department of Veterinary Pathology, Veterinary Medical Diagnostic Laboratory (Kreeger, Schmidt), and Cardiothoracic Surgery Division, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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John M. Kreeger From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine (Anderson, Payne, Mann), Department of Veterinary Pathology, Veterinary Medical Diagnostic Laboratory (Kreeger, Schmidt), and Cardiothoracic Surgery Division, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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Colette C. Wagner-Mann From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine (Anderson, Payne, Mann), Department of Veterinary Pathology, Veterinary Medical Diagnostic Laboratory (Kreeger, Schmidt), and Cardiothoracic Surgery Division, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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Donald A. Schmidt From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine (Anderson, Payne, Mann), Department of Veterinary Pathology, Veterinary Medical Diagnostic Laboratory (Kreeger, Schmidt), and Cardiothoracic Surgery Division, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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F. A. Mann From the Department of Veterinary Medicine and Surgery, College of Veterinary Medicine (Anderson, Payne, Mann), Department of Veterinary Pathology, Veterinary Medical Diagnostic Laboratory (Kreeger, Schmidt), and Cardiothoracic Surgery Division, School of Medicine (Wagner-Mann), University of Missouri, Columbia, MO 65211.

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Summary

Eight dogs were determined to be orthopedically normal on the basis of prelavage physical examination, stifle radiography, synovial fluid analysis, and force plate analysis (peak vertical force normalized for body weight, and time on the force plate). Each dog had 1 stifle randomly assigned to be lavaged with 100 ml of a commercially available 0.05% (w/v) chlorhexidine diacetate solution, and the contralateral stifle was lavaged with lactated Ringer’s solution.

Difference was not detected between the chlorhexidine diacetate and lactated Ringer’s solution-treated joints, with regard to results of synovial fluid analysis and clinical lameness evaluations on days 4 and 8 after lavage. Chlorhexidine diacetate caused a more intense synovitis than did lactated Ringer’s solution, as determined by histologic evaluation of synovial membrane specimens after necropsy on day 8; however, a difference in the intensity of toluidine blue staining of articular cartilage was not found between treatments. Chlorhexidine diacetate, as a 0.05% (w/v) solution, cannot be recommended as a joint lavage fluid until the duration of inflammatory changes in the synovial membrane are determined or until the chemical constituents of chlorhexidine diacetate causing the synovitis can be identified and removed.

Summary

Eight dogs were determined to be orthopedically normal on the basis of prelavage physical examination, stifle radiography, synovial fluid analysis, and force plate analysis (peak vertical force normalized for body weight, and time on the force plate). Each dog had 1 stifle randomly assigned to be lavaged with 100 ml of a commercially available 0.05% (w/v) chlorhexidine diacetate solution, and the contralateral stifle was lavaged with lactated Ringer’s solution.

Difference was not detected between the chlorhexidine diacetate and lactated Ringer’s solution-treated joints, with regard to results of synovial fluid analysis and clinical lameness evaluations on days 4 and 8 after lavage. Chlorhexidine diacetate caused a more intense synovitis than did lactated Ringer’s solution, as determined by histologic evaluation of synovial membrane specimens after necropsy on day 8; however, a difference in the intensity of toluidine blue staining of articular cartilage was not found between treatments. Chlorhexidine diacetate, as a 0.05% (w/v) solution, cannot be recommended as a joint lavage fluid until the duration of inflammatory changes in the synovial membrane are determined or until the chemical constituents of chlorhexidine diacetate causing the synovitis can be identified and removed.

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