Osmolarity influences chondrocyte repair after injury in human articular cartilage

Huang, Yuelong; Zhang, Yujun; Ding, Xiaoquan; Liu, Songyang; Sun, Tiezheng

doi:10.1186/s13018-015-0158-z

Cited by 21 publications

(25 citation statements)

References 26 publications

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“…Sixteen studies met the inclusion criteria and were included in this review. [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] This number is inclusive of the studies found after screening the reference sections of the initial studies ( Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Six of the sixteen included studies compared the results of irrigation solutions that had differing osmolarities. 18,[20][21][22][23][24] One out of the six studies 20 that analyzed irrigation fluids during canine shoulder arthroscopy found no statistically significant differences between normal saline and a hyperosmolar irrigation fluid when examining changes in shoulder girth, tissue water content, or chondrocyte viability. The remaining five studies found superiority with hyperosmolarity.…”

Section: Influence Of Osmolaritymentioning

confidence: 99%

“…The remaining five studies found superiority with hyperosmolarity. 18,[21][22][23][24] Amin et al determined that increasing osmolarity reduced chondrocyte death of injured cartilage in the superficial zone, which was examined via confocal laser scanning microscopy. 18 In one study, 21 articular cartilage exposed to the hyperosmotic saline solution had a six-fold (p = 0.04) decrease in chondrocyte death, after mechanical injury to the articular cartilage, when compared with normal saline using confocal laser scanning microscopy.…”

Section: Influence Of Osmolaritymentioning

confidence: 99%

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

Sardana

Burzynski

Scuderi

2019

Journal of Orthopaedics

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Arthroscopic surgery has become an important and popular orthopedic procedure for numerous joint disorders. Continuous irrigation is performed to replace synovial fluid for optimal joint distension and clear visualization of the synovial cavity. Irrigation solutions may, however, negatively impact articular cartilage and chondrocyte viability. This systematic review aims to compare different irrigating solutions and their properties to determine whether one is superior in its effects on articular cartilage and chondrocytes. Methods: A systematic literature review was conducted. The online databases: Embase, Medline, HealthStar, Emcare and PubMed were searched from 1946 to August 2018. Methodological index for non-randomized studies (MINORS) was used to assess methodological quality of the included studies. Results: Sixteen studies met the inclusion/exclusion criteria and were included in this review. Although the studies used different criteria to define superiority, solution superiority was based on results that focused on articular cartilage and chondrocyte viability. Seven of the sixteen included studies compared Ringer's/ lactate solution or Ringer's lactate to normal saline. Three found Ringer's solution or Ringer's lactate to be superior to saline, whereas, three studies found no significant differences and one study found Ringer's lactate to be inferior to saline only when their osmolarities differed. Four studies compared ionic to non-ionic solutions. Two of the four studies demonstrated non-ionic solutions to be superior, one had demonstrated no significant differences between solutions, while one had mixed results. Six of the sixteen included studies compared differing osmolarities. One found no statistically significant differences between solutions of differing osmolarities, whereas, the remaining five studies found superiority with hyperosmolarity. Two of the sixteen included studies examined the effects of different temperatures. Both studies concluded that the use of a warmer (more physiological) temperature is more ideal. Two of the sixteen studies included in this review compared solutions with differing pH levels. Both studies concluded on the importance of utilizing the more physiological solutions for arthroscopic procedures. Conclusion: Ringer's Lactate and Ringer's Solution as well as non-ionic solutions may have merit over the use of the normal saline for irrigation. Hyperosmolarity, warmer solutions and ones with more physiological pH values may be beneficial when considering potential effects on articular cartilage and chondrocytes. The current review demonstrated trends found in the current literature, which require human studies-preferably high quality RCTs-to make recommendations that aid surgeons in making the best decision regarding the ideal irrigation solution to use on their patients.

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Section: Resultsmentioning

confidence: 99%

Section: Influence Of Osmolaritymentioning

confidence: 99%

Section: Influence Of Osmolaritymentioning

confidence: 99%

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

Sardana

Burzynski

Scuderi

2019

Journal of Orthopaedics

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“…Inwieweit dies durch die Art der Spülflüssigkeit und Abkühlungseffekte vermittelt wird, bedarf noch weiterer Abklärung. Interessanterweise konnten hyperosmolare arthroskopische Spüllösungen bei akuten Knorpelschädigungen Zelltod und Proteoglykanverlust reduzieren [57,60]. Weiterhin wurden für hyaluronsäurehaltige Präparate oder plättchenreiches Plasma, die am Ende einer Arthroskopie appliziert wurden, positive Effekte beschrieben [61,62].…”

Section: Beeinflussung Der Gelenkhomöostase Durch Eine Arthroskopischunclassified

Stellenwert des Débridements bei der Behandlung fokaler (Grad II – III) Knorpelschäden des Kniegelenks. Systematische Literaturübersicht und Empfehlungen der AG Geweberegeneration (DGOU)

Gelse

Angele

Behrens³

et al. 2018

Z Orthop Unfall

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The decision criteria for debridement of partial thickness focal cartilage lesions are multifactorial and include the clinical symptoms, the size and the degree of the defect, the stability of remaining cartilage, localisation of the defect, and individual patient-specific parameters. Debridement is not recommended for asymptomatic lesions, but may be reasonable for symptomatic cases with unstable tissue.

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“…A study reported the weight gain of patients with hypertonic irrigation was 2.25 ± 0.77 kg and the use of hypertonic lavage did not increase operating time [27]. Studies also have shown isotonic or hypotonic extracellular uid might aggravate the death of chondrocytes in articular cartilage [28]. In contrast, hypertonic lavage uid had a protective effect on articular cartilage [29].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary edema lead by circulation overload following shoulder arthroscopy under general anesthesia with nerve block: an observational study

Zhang

Wan

Huang

et al. 2020

Preprint

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Purpose : Shoulder arthroscopy requires a large of irrigation for a better surgical view, resulting in circulatory overload. This study was performed to p rove whether pulmonary edema will be lead by a large of irrigation . Materials and Methods : General anesthesia with interscalene block was induced before operation. The primary outcome was ultrasound evaluation of B lines from the time before nerve block to the time 10 hours after operation. The secondary outcomes included oxygenation index, arterial partial pressure of carbon dioxide, visual analogue scale, muscle strength grade. Results : A total of 93 patients were evaluated. Before surgery, B lines failed to be detected. While the highest total incidence of B lines was 49.4%, occured at 4 hours after surgery. The highest incidence s of severe and moderate pulmonary edema were 3.2% (P=0.081) and 9.7% (P=0.002), respectively. B lines were also found on both the affected and healthy side. During operation, the incidence of type 1 respiratory failure was 5.4% (P=0.023) and that of both type 1 and 2 respiratory failure were 6.5% (P=0.013). Pain was relieved in 6 hours after surgery (VAS<3). At 12 hours after operation, the VAS of resting and motion were 4.68±2.27, 6.90±2.43, respectively. While the grade of muscle strength was 4.48±0.51 at 12 hours after operation. Conclusions : There is a high incidence of pulmonary edema in shoulder arthroscopy, and ultrasound is an convenient tool to evaluate this complication . Pain is relieved in 6 hours after surgery by nerve block. While muscle strength can also recover at 12 hours after surgery.

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Osmolarity influences chondrocyte repair after injury in human articular cartilage

Cited by 21 publications

References 26 publications

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

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

Stellenwert des Débridements bei der Behandlung fokaler (Grad II – III) Knorpelschäden des Kniegelenks. Systematische Literaturübersicht und Empfehlungen der AG Geweberegeneration (DGOU)

Pulmonary edema lead by circulation overload following shoulder arthroscopy under general anesthesia with nerve block: an observational study

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