Increased Chondrocyte Death after Steroid and Local Anesthetic Combination

Abstract

Background Hyaline articular cartilage has limited repair and regeneration capacity. Intraarticular administration of glucocorticoid and local anesthetic injections play an important role in the therapy of osteoarthritis. Glucocorticoids and anesthetics reportedly enhance apoptosis in chondrocytes, but effects of the combined use of glucocorticoids and local anesthetics are unknown. Questions/purposes We asked whether glucocorticoid and local anesthetic agents combined had any synergistic effects on chondrocyte apoptosis. Methods Cell viability and apoptosis/necrosis assessment of human articular chondrocytes were performed in vitro (chondrocyte cell cultures) and ex vivo (osteochondral specimens) using flow cytometry and TUNEL analysis, respectively.

Quantitative T2 mapping of femoral head cartilage in systemic lupus erythematosus patients with noncollapsed osteonecrosis of the femoral head associated with corticosteroid therapy

“…There were several reports about morphological influence of corticosteroids and inflammatory condition to the cartilage appearance. Farkas et al (32) reported that glucocorticoids and local anesthetics induced apoptosis in chondrocytes especially in the superficial layer of the osteochondral specimens. Fubini et al (33) also suggested that methylprednisolone suppressed matrix protein markers of chondrocytic differentiation and that the altered chondrocyte expression of matrix proteins likely contributed to the pathogenesis of corticosteroid-induced cartilage degeneration.…”

Articular cartilage and local anaesthetic: A systematic review of the current literature

“…14,15 The use of a cartilage culture medium instead is likely to have shown more toxicity with ropivacaine. Farkas et al 16 found that even ropivacaine can be harmful to articular cartilage when used at a higher concentration.…”

Bilateral Knee Osteonecrosis After Intraarticular Concomitant Local Anesthetic and Corticosteroid Injection: A Case Report

“…Injections of corticosteroid and local anesthetics combinations cause increased damage to chondrocytes. In an in-vitro and ex vivo study, Farkas et al have concluded that the combination of corticosteroid and local anesthetics has an increased adverse effect on articular chondrocytes (13,14). In an in-vitro study, Seshadri et al have shown a dose-and time-dependent decrease in chondrocyte viability after exposure to clinically relevant doses of methylprednisolone.…”