Chondrotoxicity of Liposomal Bupivacaine in Articular Chondrocytes: Preliminary Findings

Abstract

Following 1 hour of treatment, liposomal bupivacaine demonstrated the highest chondrocyte viability. Chondrocyte viability was inversely proportional to anesthetic concentration.

Plasma and synovial fluid concentrations and cartilage toxicity of bupivacaine following intra‐articular administration of a liposomal formulation to horses

“…By virtue of the formulation, this product has a longer duration of analgesic effect compared to bupivacaine HCl [15,19]. Although not currently approved for IA administration, a recent report describing the effects of liposomal bupivacaine on bovine and porcine chondrocyte viability, is encouraging with respect to the safety of this drug for IA use [16,17]. In the presently described study, we report on the plasma pharmacokinetics and synovial fluid concentrations of liposomal bupivacaine as well as chondrotoxicity following IA administration to horses.…”

“…A secondary objective of this study was to assess the potential chondrotoxicity of liposomal bupivacaine following IA administration. Shaw and colleagues recently assessed the effects of liposomal bupivacaine on cell viability in cultured bovine chondrocytes. While decreased cell viability was noted in the chondrocytes incubated with bupivacaine HCl, no significant difference in cell count was found between cells treated with liposomal bupivacaine and 0.9% saline .…”

“…Liposomal bupivacaine formulations are not currently approved by the FDA for IA administration in any species, however, presumably slow release over time would lead to lower overall exposure to bupivacaine, compared to the HCl formulation at a given time. In an in vitro model, Shaw and colleagues reported no effects on chondrocyte viability, relative to control, following treatment of bovine chondrocytes with liposomal bupivacaine . In a subsequent study, the same group of investigators studied the effects of liposomal bupivacaine on porcine chondrocytes in vivo following IA administration .…”

Chondrotoxicity of Local Anesthetics: Liposomal Bupivacaine Is Less Chondrotoxic than Standard Bupivacaine

“…Other studies showed chondrotoxicty at higher concentrations of 0.75% [19]. Shaw compared rovicapaine with liposomal bupivacaine, demonstrating higher viability of chondrocytes in the liposomal group [16].…”

“…A novel formulation of liposomal bupivacaine has recently been introduced, but there is a paucity of data published regarding the safety of intra-articular liposomal bupivacaine. Shaw et al harvested bovine knee cartilage and isolated the chondrocytes in the medium prior to exposure to liposomal bupivacaine, bupivacaine, and ropivacaine [16]. eir results showed that after a 1-hour exposure to liposomal bupivacaine, chondrocyte viability was similar to the control.…”