# N-chlorotaurine does not alter structural tendon properties: a comparative biomechanical study

## TL;DR

This study shows that N-chlorotaurine does not harm tendon properties, making it a safe alternative to vancomycin for preventing infections after surgery.

## Contribution

Demonstrates that NCT does not alter tendon biomechanics, supporting its clinical use as an antiseptic.

## Key findings

- NCT and vancomycin did not significantly affect tendon structural properties.
- No differences in ultimate load, elongation, or stiffness were found between solutions.
- NCT is biomechanically safe for use in surgical settings.

## Abstract

N-chlorotaurine (NCT) is a well-tolerated antiseptic with broad-spectrum microbicidal activity and could therefore be a promising alternative to vancomycin, the current standard of care for the prevention of postoperative septic arthritis (PSA) after anterior cruciate ligament reconstruction (ACLR).

The aim of this study was to evaluate whether soaking bovine extensor tendons in N-chlorotaurine (NCT), vancomycin, or 0.9% saline influences structural tendon properties. In this controlled biomechanical study, fifty bovine extensor tendons were randomized into groups and soaked for 10 min in distilled water solutions containing either 1% vancomycin, 1% NCT, 5% NCT, 5% NCT with 0.1% ammonium chloride, or 0.9% saline. Tendons were then mounted in cryo-clamps and subjected to uniaxial tensile testing until failure. Failure mode, ultimate load, ultimate elongation, and stiffness of the linear region from the load-elongation curve were extracted and compared for each graft.

No statistically significant differences were detected across all measured parameters (p > 0.05) and solutions. The mean ultimate load, ultimate elongation, stiffness and elastic modulus were not statistically significantly different between all five tested solutions.

Both NCT and vancomycin even at high concentrations do not impair structural tendon properties compared to 0.9% saline. NCT appears to be safe for clinical use from a biomechanical perspective.