Common Injections in Musculoskeletal Medicine

Monseau, Aaron J.; Nizran, P.

doi:10.1016/j.pop.2013.08.012

Cited by 16 publications

(10 citation statements)

References 30 publications

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“…Monseau et al [ 48 ] presented a list of absolute and relative contraindications to musculoskeletal injections (including both the CS and HA injections) on the basis of the literature. The absolute contraindications to intraarticular injections are: hypersensitivity to CS or any other type of injectable substance, systemic infection or infection in the area of the planned injection (cellulitis, septic arthritis, septic bursitis, osteomyelitis), uncontrolled bleeding disorder, prosthetic or unstable joint and finally intraarticular fracture [ 48 ]. The relative contraindications to intraarticular injections are: treated bleeding disorder, hemarthrosis, anticoagulants, immunosuppression, diabetes, increased risk of tendon rupture and pain of psychogenic origin [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

Derwich¹,

Mituś-Kenig

Pawłowska

2021

IJMS

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Temporomandibular joint osteoarthritis (TMJ OA) is a low-inflammatory disorder with multifactorial etiology. The aim of this review was to present the current state of knowledge regarding the mechanisms of action and the efficacy of hyaluronic acid (HA), corticosteroids (CS) and platelet-rich plasma (PRP) in the treatment of TMJ OA.: The PubMed database was analyzed with the keywords: “(temporomandibular joint) AND ((osteoarthritis) OR (dysfunction) OR (disorders) OR (pain)) AND ((treatment) OR (arthrocentesis) OR (arthroscopy) OR (injection)) AND ((hyaluronic acid) OR (corticosteroid) OR (platelet rich plasma))”. After screening of 363 results, 16 studies were included in this review. Arthrocentesis alone effectively reduces pain and improves jaw function in patients diagnosed with TMJ OA. Additional injections of HA, either low-molecular-weight (LMW) HA or high-molecular-weight (HMW) HA, or CS at the end of the arthrocentesis do not improve the final clinical outcomes. CS present several negative effects on the articular cartilage. Results related to additional PRP injections are not consistent and are rather questionable. Further studies should be multicenter, based on a larger group of patients and should answer the question of whether other methods of TMJ OA treatment are more beneficial for the patients than simple arthrocentesis.

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Section: Resultsmentioning

confidence: 99%

Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

Derwich¹,

Mituś-Kenig

Pawłowska

2021

IJMS

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“…A commonly used 22-gauge cannula for orthopedic injections was used in this study. 47,48 All of the HA compositions required less than 1 N of force to extrude. A study by Kim et al 49 developed a collagen/HA injectable composite filler which required 10-12 N of force to extrude through a 27-gauge cannula.…”

Section: Discussionmentioning

confidence: 99%

Investigation of an injectable gold nanoparticle extracellular matrix

Snider

Grant

2021

J Biomater Appl

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Post-traumatic osteoarthritis (PTOA) is a progressive articular degenerative disease that degrades articular cartilage and stimulates apoptosis in chondrocyte cells. An injectable decellularized, extracellular matrix (ECM) scaffold, that might be able to combat the effects of PTOA, was developed where the ECM was conjugated with 20 nm gold nanoparticles (AuNP) and supplemented with curcumin and hyaluronic acid (HA). Porcine diaphragm ECM was decellularized and homogenized; AuNPs were conjugated using chemical crosslinking followed by mixing with curcumin and/or HA. Injection force testing and scanning electron microscopy with energy-dispersive X-ray spectroscopy were utilized to characterize the ECM scaffolds. In vitro testing with L929 murine fibroblasts, equine synovial fibroblasts, and Human Chondrocytes were used to determine biocompatibility, reactive oxygen species (ROS) reduction, and chondroprotective ability. The results demonstrated that conjugation of 20 nm AuNPs to the ECM was successful without significantly altering the physical properties as noted in the low injection force. In vitro work provided evidence of biocompatibility with a propensity to reduce intracellular ROS and an ability to mitigate apoptosis of chondrocyte cells stimulated with IL-1β, a known apoptosis inducing cytokine. It was concluded that an injectable AuNP-ECM may have the ability to mitigate inflammation and apoptosis.

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“…A 20-gauge cannula was used to measure the extrusion force of all constructs. A gauge of 18 -23 is commonly used for intra-articular injections of steroids into the knee [31] [32]. It is important to have a cannula that is large enough for the material to pass through while small enough for the physician to have control.…”

Section: Discussionmentioning

confidence: 99%

Homogenized Porcine Extracellular Matrix Derived Injectable Tissue Construct with Gold Nanoparticles for Musculoskeletal Tissue Engineering Applications

Smith¹,

Snider²,

Gilley³

et al. 2017

JBNB

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A unique porcine extracellular matrix (ECM) derived injectable tissue construct with 100 nm or 20 nm gold nanoparticles (AuNP) was developed for musculoskeletal tissue engineering applications. ECM has been shown to encourage cellularity and tissue remodeling due to its release of growth factors while AuNP have been shown to reduce reactive oxygen species (ROS) levels. Injectable tissue constructs were created by homogenizing decellularized porcine diaphragm tendon conjugated with 100 nm or 20 nm AuNP at 1x, 4x, and 8x concentrations. Extrusion force testing demonstrated that homogenized tissue constructs were injectable at an appropriate cannula size and force. L-929 murine fibroblasts were used to measure cell viability, cell proliferation, intracellular ROS levels, and cell migration in response to constructs. Enhanced cell viability and proliferation are observed on 1 × 20 nm AuNP constructs. ROS assays demonstrate reduced cellular ROS concentrations from all 20 nm AuNP constructs and from 8 × 100 nm AuNP constructs compared with constructs without nanoparticles. Cellular migration is higher towards 4 × 20 nm AuNP constructs compared with constructs without nanoparticles. Results support the potential use of a porcine ECM derived injectable tissue construct with AuNP as an injectable tissue construct to reduce inflammation and to promote tissue remodeling in musculoskeletal tissue engineering applications.

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Common Injections in Musculoskeletal Medicine

Cited by 16 publications

References 30 publications

Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis—A Systematic Review

Investigation of an injectable gold nanoparticle extracellular matrix

Homogenized Porcine Extracellular Matrix Derived Injectable Tissue Construct with Gold Nanoparticles for Musculoskeletal Tissue Engineering Applications

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