Arthroscopic irrigation of the bovine stifle joint increases cartilage surface friction and decreases superficial zone lubricin

Abstract

The purpose of this study was to determine the effects of arthroscopic irrigation on cartilage superficial zone lubricin and surface friction. Arthroscopic partial meniscectomy is one of the most commonly performed orthopaedic surgeries in the United States, but rates of osteoarthritis progression following this procedure are high. The effect of arthroscopic irrigation on articular surface lubrication has not been previously considered as a contributing factor in outcomes after arthroscopy. Fourteen bovine stifle joints were randomized to receive arthroscopic irrigation (n=7) or no treatment (n=7). Full-thickness osteochondral explants from these joints underwent friction testing to measure static and dynamic coefficients of friction. Following mechanical testing, samples were fixed and stained for lubricin. Percent integrated density, a measure of the amount of lubricin in the superficial zone (0–100um depth), was determined. Static and dynamic coefficients of friction were found to be significantly greater in arthroscopy specimens compared to controls (p=0.02 and p<0.001, respectively). Percent integrated density of lubricin in the superficial zone was significantly lower in arthroscopy specimens compared to controls (p<0.001).

Temporal changes in synovial fluid composition and elastoviscous lubrication in the equine carpal fracture model

“…It is intuitive that HA concentrations would be decreased following arthroscopy and saline lavage. Recent studies have demonstrated that lavage reduces lubricin staining at the cartilage surface 45,46 and results in impaired boundary friction properties of cartilage. 45,46 However, it was surprising that the loss of high molecular weight HA was sustained for so long following fracture, especially given how quickly lubricin concentrations recovered.…”

Two compartment pharmacokinetic model describes the intra‐articular delivery and retention of rhprg4 following ACL transection in the Yucatan mini pig

“…A relatively low amount of joint cavity irrigation was used during arthroscopy. Irrigation has been shown to eliminate the resident lubricin in the bovine joint . The lower amounts of irrigation used for this surgical injury may have resulted in the rhPRG4 mixing with resident porcine PRG4 which could impact its bioavailability.…”

The influence of the irrigating solution on articular cartilage in arthroscopic surgery: A systematic review

“…Discussion between two reviewers took place to address disagreements, and if needed, the senior author resolved issues related to study selection. Studies were included if they contained: [1] irrigating solutions; [2] implications for/focus on arthroscopy; [3] examination of the effects on articular cartilage/chondrocytes [4] joints of the extremities; [5] comparison(s) of different solutions or the same solution with different properties (such as temperature, osmolarity, or pH); [6] primary article; [7] short term exposure to irrigation fluids; and [8] full text. The following components were made part of the exclusion criteria: [1] studies lacking a comparator group; [2] studies without an arthroscopic focus; [3] studies focusing on epinephrine/norepinephrine; [4] studies focusing only on electrosurgery in arthroscopy; [5] studies not examining the effects on articular cartilage or chondrocytes; [6] studies that are not available or full-text not accessible; [7] conference proceedings or abstracts; and [8] literature reviews and case reports.…”

“…2 Since articular cartilage is dependent on the synovial fluid for its nutrition, it is sensitive to these changes. 3,4 Irrigation fluids used during arthroscopic surgery may result in increased elimination of proteoglycans out of the tissue, subjecting articular cartilage to potential mechanical injury 5 and resulting in matrix degradation and chondrocyte death. [6][7][8] Articular cartilage chondrocytes are, however, crucial to the synthesis of the proteoglycan and collagen of the extracellular matrix, as well as the essential enzymes for building and degrading them.…”