Increased Chondrocyte Death after Steroid and Local Anesthetic Combination (original) (raw)
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Cartilage, 2015
Objective: Intra-articular injection of local anesthetic and/or corticosteroid is an adjunct treatment for arthritic and inflammatory orthopedic conditions. Despite potential benefits, there is growing concern that these medications may cause significant morbidity, including potential toxicity to intra-articular chondrocytes and synoviocytes. Design: Twenty dogs underwent intra-articular injection of the shoulder joint using ultrasound guidance, with the following injectates ( n = 5 each): negative control (saline), methylprednisolone/1.0% lidocaine, triamcinolone/1.0% lidocaine, and triamcinolone/0.0625% bupivacaine. The dogs were euthanized 24 hours postinjection for reasons unrelated to this study. Synovium/cartilage explants were harvested under sterile conditions and assessed immediately or cultured for 7 days. Synoviocyte and chondrocyte viability was determined on day 1 and day 7 using Calcien AM and Sytox Blue live/dead fluorescent stains, and cell metabolism determined on d...
The viability of chondrocytes after an in vivo injection of local anaesthetic and/or corticosteroid
The Bone & Joint Journal, 2015
This in vivo controlled laboratory study was performed to evaluate various intra-articular clinical injection regimes that might be less toxic than some in vitro studies suggest. We hypothesised that low-concentration, preservative-free, pH-balanced agents would be less toxic than high-concentration non-pH-balanced agents with preservatives, and that injections of individual agents are less toxic than combined injections. The left knees of 12- to 13-week-old Sprague–Dawley rats were injected once with eight different single agents, including low and high concentrations of ropivacaine and triamcinolone, alone and in combination, as well as negative and positive controls. The rats were killed at one week or five months, and live–dead staining was performed to quantify the death of chondrocytes. All injections except pH-balanced 0.2% ropivacaine combined with preservative-free 1 mg/ml triamcinolone acetonide resulted in statistically significant decreases in chondrocyte viability, comp...
International Journal of Molecular Sciences, 2021
The current study aimed to investigate the cytotoxicity of co-administrating local anesthetics (LA) with glucocorticoids (GC) and hyaluronic acid (HA) in vitro. Human articular cartilage was obtained from five patients undergoing total knee arthroplasty. Chondrocytes were isolated, expanded, and seeded in 24-well plates for experimental testing. LA (lidocaine, bupivacaine, ropivacaine) were administered separately and co-administered with the following substances: GC, HA, and GC/HA. Viability was confirmed by microscopic images, flow cytometry, metabolic activity, and live/dead assay. The addition of HA and GC/HA resulted in enhanced attachment and branched appearance of the chondrocytes compared to LA and LA/GC. Metabolic activity was better in all LA co-administered with HA and GC/HA than with GC and only LA. Flow cytometry revealed the lowest cell viability in lidocaine and the highest cell viability in ropivacaine. This finding was also confirmed by live/dead assay. In conclusio...
BMC veterinary research, 2015
Intra-articular injection of corticosteroids is used to treat the inflammatory pain of arthritis and osteoarthritis (OA), but our previous study found a deleterious effect of these steroids on chondrocyte cells. Hyaluronic acid (HA) injection has been suggested as a means to counteract negative side effects through replenishment of synovial fluid that can decrease pain in affected joints. To better understand the effects of corticosteroids on these processes, dexamethasone (Dex) and prednisolone (Pred) were administered to porcine cartilage explants at several concentrations with and without HA. We examined corticoid effects by determining sulfate-glycosaminoglycan (s-GAG) and uronic acid (UA) content of the explant media, and safranin-O staining of the cells. Analysis of lactate dehydrogenase (LDH) activity was conducted to assess cell cytotoxicity. Dex treatment significantly reduced cellular cytotoxicity compared to the other treatment groups, especially with regards to the relea...
Biomedicines
Intra-articular injections of glucocorticoids (GC) or hyaluronic acid (HA) are commonly used interventions for patients suffering from knee osteoarthritis (OA). Both substances are combined to achieve a chondroprotective and anti-inflammatory effect. Clinical studies have shown benefits, but data on the cellular level are still lacking. This study aimed to investigate the effect of the GC triamcinolone hexacetonide, HA, and a mix of both substances on cytokine-treated chondrocytes in vitro. Chondrocytes isolated from human articular cartilage were seeded on 6- and 24-well plates. Mimicking OA’s inflammatory state, cells were treated with IL-1β and IL-17 for six days, whereby, after three days, test substances (10%) were added to the culture medium. Chondrocytes were analyzed on days three and six concerning their actin polymerization, expression of anabolic and catabolic genes, metabolic activity, cytokine release, and reactive oxygen species (ROS). Adding HA or GC/HA to the inflamm...
Clinical and experimental rheumatology
I In nt tr ro od du uc ct ti io on n Osteoarthritis (OA) is a degenerative joint disease resulting in cartilage erosion, subcondral bone remodeling, osteophyte formation and synovial inflammation. Although OA might have multiple origins, current evidence suggests that both mechanical and biochemical factors play an important role in its progression (1). Although there is no treatment method for which efficacy has been proven in preventing or reversing the structural changes caused by OA which is the most prevalent joint disease, an appropriate treatment may improve the quality of life of the 90 S Su um mm ma ar ry y O Ob bj je ec ct ti iv ve e: : To examine the effect of intraarticular injections of methylprednisolone, hyaluronic acid and therapeutic ultrasound on osteoarthritic lesions in experimental severe osteoarthritis (OA). M Ma at te er ri ia al ls s a an nd d M Me et th ho od ds s: : Thirty five adult white New Zealand rabbits were used in this study. The experimental OA was induced by the injection of papain (2 mg) to the knee joints bilaterally. Five weeks after the intraarticular injection of papain, rabbits were divided into 3 groups. Group 1: In 12 rabbits, 20 mg methylprednisolone was injected into the right knee once weekly for three weeks. Group 2: In 10 rabbits, 0.4 ml of HA (concentration 15 mg per ml) was injected into the right knee once weekly for three weeks. Group 3: In 10 rabbits 7 min. pulse sonication (US) was applied to the right knees with an intensity of 0.5 W/cm 2 once daily for a total of 10 times. The left knee joints were used as controls. Surface cartilage lesions on the condyles and plateaus was evaluated macroscobically, where as lesion severity was evaluated histologically. R Re es su ul lt ts s: : There were no significant differences between the groups for macroscopic and histologic grades of cartilage lesions on condyles and plateaus at the end of the treatment (p>0.05). Furthermore no statistically significant difference was observed between the treated and control knees of the rabbits in each group (p>0.05). C Co on nc cl lu us si io on n: : In this study, none of the treatments applied were found to be effective in cartilage lesions in severe OA. Turk J Phys Med Rehab 2006;52:90-5 K Ke ey y W Wo or rd ds s: : Experimental osteoarthritis, management Ö Öz ze et t A Am ma aç ç: : Deneysel fliddetli osteoartritte (OA), intraartiküler metilprednizalon, hyaluronik asit (HA) ve terapötik ultrasonun, osteoartrit lezyonlar› üzerine etkisini incelemek. G Ge er re eç ç v ve e Y Yö ön nt te em m: : Otuzbefl adet New Zealand tipi yetiflkin tavflan çal›flmaya al›nd›. Her iki dize, 2 mg papain enjeksiyonu ile deneysel OA oluflturuldu. ‹ntraartiküler papain enjeksiyonundan 5 hafta sonra tavflanlar 3 gruba ayr›ld›. Grup 1'deki 12 tavflan›n sa¤ dizine, 1 hafta ara ile 3 hafta boyunca, 20 mg metilprednizolon enjekte edildi. Grup 2'deki 10 tavflan›n sa¤ dizine, 1 hafta ara ile 3 hafta boyunca, 0,4 ml HA (konsantrasyon; 15 mg/ml) enjekte edildi. Grup 3'deki 10 tavflan›n sa¤ dizine, yo¤unlu¤u 0,5 W/cm 2 olmak üzere, 7 dakika puls US tedavisi 10 kez uyguland›. Sol dizler kontrol olarak al›nd›. Kondil ve platolardaki kartilaj lezyonlar›n›n ölçümü makroskobik de¤erlendirme ile, lezyon fliddeti ise histolojik de¤erlendirme ile yap›ld›. B Bu ul lg gu ul la ar r: : Tedavi sonunda, kondil ve platodaki kartilaj lezyonlar›n›n makroskobik ve histolojik evreleri aras›nda gruplar aras›nda istatistiksel an-laml› fark gözlenmedi (p>0,05). Her gruptaki tavflanlar›n tedavi edilen ve kontrol dizleri aras›nda da anlaml› de¤ifliklik saptanmad› (p>0,05). S So on nu uç ç: : Bu çal›flmada, fliddetli osteoartritteki kartilaj lezyonlar›nda, uygulanan tedavilerden hiçbiri etkili bulunmam›flt›r.