Reduced Chondrocyte Viability Is Associated With the Use of Surgical Marker Pen Ink

Background: Sterile surgical marker pens are commonly used in cartilage repair surgery to aid in the placement of periosteal patches or collagen membranes in autologous chondrocyte implantation. Purpose: To investigate the effects that methylene blue and crystal violet marker pen ink have on human c...

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Bibliographic Details
Published in:The American journal of sports medicine 2011-06, Vol.39 (6), p.1270-1274
Main Authors: Getgood, Alan, McNamara, Iain, Kili, Sven, Bhullar, Tony, Henson, Frances
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Cell Count
Cell Survival
Cells, Cultured
Chondrocytes - drug effects
Collagen
Collagen Type I
Collagen Type III
Coloring Agents - adverse effects
Diseases of the osteoarticular system
Gentian Violet - adverse effects
Humans
Medical sciences
Membranes
Membranes, Artificial
Methylene Blue - adverse effects
Orthopedics
Sports injuries
Sports medicine
Swine
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Summary:Background: Sterile surgical marker pens are commonly used in cartilage repair surgery to aid in the placement of periosteal patches or collagen membranes in autologous chondrocyte implantation. Purpose: To investigate the effects that methylene blue and crystal violet marker pen ink have on human chondrocytes when cultured on collagen membranes in vitro. Study Design: Controlled laboratory study. Methods: Human chondrocytes were applied to Chondro-Gide collagen membranes at a volume of 12 million cells. In the first experiment, 2 sterile marker pens, one containing methylene blue and the other crystal violet inks, were used to mark membranes immediately before the addition of cells. In the second experiment, the same marker pens marked the membranes after 7 days of cell culture. In each experiment, 3 groups of membrane were tested for each pen. Group A consisted of no ink mark, group B had only the uppermost “smooth” layer marked, and group C had the lower “porous” layer marked. All membranes were then cultured in standard growth media for 24 hours. Cell viability was assessed at 24 hours on all membranes using a live/dead-cell viability assay. Cell viability was quantified with florescent microscopy with mean percentage of live cells in each marker pen group compared with control membranes using the Student t test (P < .05). Results: Control membranes (group A) with no ink showed cell viability approaching 100%. A statistically significant reduction in cell viability with both methylene blue (23.1%; P < .0001) and crystal violet (18.9%; P < .0001) was found adjacent to the ink mark on the smooth side (group B) and on the porous side remote from the ink (group C) in both experiments (
ISSN:0363-5465
1552-3365
DOI:10.1177/0363546510396315