Instrumentation

McIlwraith, C. Wayne

doi:10.1016/b978-0-7234-3693-5.00002-3

Cited by 6 publications

(4 citation statements)

References 35 publications

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“…Lactated Ringer's solution (273 mOsm/L) is the standard-of-care irrigation solution used for equine arthroscopic surgery. [9][10][11] Normal saline (0.9% NaCl solution and 300 mOsm/L) has been shown to inhibit synthesis of GAG by chondrocytes and has therefore fallen out of favor in recent years. 21 The proteoglycan content of the extracellular matrix dictates the osmolality of the extracellular environment to which cartilage is exposed.…”

Section: Discussionmentioning

confidence: 99%

The use of a hyperosmolar irrigation solution is safe in an equine stifle joint model but does not reduce joint swelling

Hayden

Stoker

Johnson

et al. 2022

ajvr

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OBJECTIVE To determine the following: (1) whether an irrigation solution that is hyperosmolar (HYPER) relative to synovial fluid decreases tissue extravasation during an arthroscopic protocol when compared to a relatively hypoosmolar solution, (2) the safety of a HYPER solution based on viability of joint tissues following joint irrigation, and (3) if the use of a HYPER solution decreases water content in stifle joint tissue. ANIMALS 8 adult horses. PROCEDURES A prospective, blinded, randomized controlled trial was performed to compare lactated Ringer’s solution (LRS; 273 mOsm/L) and a HYPER (600 mOsm/L) irrigation solution for routine medial femorotibial joint (MFTJ) arthroscopy. Primary outcomes included quantification of periarticular fluid retention based on measured changes in defined stifle joint girth and ultrasonographic (US) criteria. Water content of tissue samples was assessed. The viability of articular cartilage was determined using a microscopic fluorescent cell viability staining system. RESULTS No significant difference in postprocedural joint swelling was observed between LRS and HYPER treatment groups. Percent increments in femorotibial joint dimensions (mean ± SD) were seen in both treatment groups based on US (LRS, 83.9 ± 84.6%; HYPER, 131.2 ± 144.9%) and caliper measurements (LRS 5.5 ± 4.3%; HYPER 7.5 ± 5.8%) (P ≤ .05). Chondrocyte viability and tissue water content were maintained in both treatment groups, and differences were not statistically significant. CLINICAL RELEVANCE Doubling the osmolarity of an irrigation solution used routinely for arthroscopy does not result in detrimental effects on chondrocyte viability or tissue water content. However, use of a relatively HYPER irrigation solution did not attenuate procedural tissue swelling of the equine stifle joint.

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Section: Discussionmentioning

confidence: 99%

The use of a hyperosmolar irrigation solution is safe in an equine stifle joint model but does not reduce joint swelling

Hayden

Stoker

Johnson

et al. 2022

ajvr

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“…Arthroscopic irrigation is presently routinely achieved using a balanced electrolyte solution such as LRS (273 mOsm/L), which is hypoosmolar relative to normal equine synovial fluid (350-450 mOsm/L). 2,6,7 This (surgically induced and temporary) Recently published work using a canine arthroscopy model, the mean percentage change in shoulder girth was higher in the control (isosmolar) group than the hyperosmolar group (600 mOsm/L), and there was no significant change in water content or chondrocyte viability. 27 The study was translated to a human clinical trial, which demonstrated that a hyperosmolar group (593 mOsm/L) experienced significantly less mean weight gain, less change in shoulder girth, and a lower immediate postoperative visual analog scale pain score.…”

Section: Hyperosmolar Irrigationmentioning

confidence: 99%

“…3 Normal equine synovial fluid has an osmolarity of 350-450 mOsm/L. 2,6,7 The osmolarity of the articular cartilage and other joint tissues can change in response to changes in synovial fluid osmolarity, joint health, and static loading. 7 A previous study in humans found that following exercise, hyaluronic acid concentrations and osmolality are decreased, and synovial fluid volume is increased, compared to unexercised controls.…”

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Evaluation of a relatively hyperosmolar irrigation solution for use in equine femorotibial arthroscopy

Hayden¹

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Hyperosmolar irrigation solutions have been shown to decrease fluid extravasation during arthroscopic procedures and safety has been demonstrated in canine and human studies. Prospective, blinded, randomized controlled trial was performed to compare lactated Ringer's solution (273 mOsm/L) and a hyperosmolar (600 mOsm/L) irrigation solution for an exploratory medial femorotibial joint arthroscopy. Primary outcomes focused on the amount of periarticular fluid retention based on change in stifle girth and ultrasonographic (US) measurements. The water content of the tissue samples was assessed, and viability of the cartilage tissue was determined. The objectives of this study were to determine: (1) whether an irrigation solution that is hyperosmolar relative to synovial fluid decreases tissue extravasation during an arthroscopic protocol when compared to a relatively hypoosmolar solution, (2) the safety of a hyperosmolar solution by assessing the viability of joint tissues after joint irrigation, (3) if the use of a hyperosmolar solution decreases water content in stifle tissue. There was not a significant difference in joint swelling between hyperosmolar (Hyper) and lactated Ringer's solution (LRS) treatment groups. Percent increments in femorotibial joint dimensions (mean [plus or minus] S.D.) were seen in both treatment groups based on US (LRS, 83.9 [plus or minus] 84.6 percent; HYPER, 131.2 [plus or minus] 144.9 percent) and caliper measurements (LRS 5.5 [plus or minus] 4.3 percent; HYPER 7.5 [plus or minus] 5.8 percent) (p[less than or equal to]0.05). Chondrocyte viability and tissue water content were well maintained in both treatment groups, and differences were not statistically significant. These findings suggest that approximately doubling the osmolarity of the standard irrigation solution used for arthroscopy did not result in detrimental effects on chondrocyte viability or tissue water content, it did not significantly reduce tissue swelling.

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Fractures of the Proximal Sesamoid Bones

Wright

2019

Equine Fracture Repair

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Instrumentation

Cited by 6 publications

References 35 publications

The use of a hyperosmolar irrigation solution is safe in an equine stifle joint model but does not reduce joint swelling

The use of a hyperosmolar irrigation solution is safe in an equine stifle joint model but does not reduce joint swelling

Evaluation of a relatively hyperosmolar irrigation solution for use in equine femorotibial arthroscopy

Fractures of the Proximal Sesamoid Bones

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