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Clinical and pathological changes in the knee after accidental chlorhexidine irrigation during arthroscopy

CASE REPORTS AND REVIEW OF THE LITERATURE

Department of Orthopaedic Surgery

A. Vermeulen, MD

Department of Pathology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands.

Correspondence should be sent to Dr C. M. Douw.

We describe six knees in five patients, referred to us after accidental irrigation with chlorhexidine 1% in aqueous solution during arthroscopy.

All six knees developed persisting pain, swelling and crepitus with loss of range of movement. Radiographs showed loss of joint space in all three compartments due to extensive chondrolysis, with many loose bodies and synovitis. Histological examination showed partial necrosis of the cartilage, with slight non-specific inflammation and fibrosis of synovial specimens.

Care is needed in checking irrigation fluids, and these should have a distinctive colour.