Postoperative synovial fluid metabolic response to meniscectomy or synovectomy

Niinikoski, J; Einola, Sakari

doi:10.3109/17453677708985123

Cited by 15 publications

(3 citation statements)

References 11 publications

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“…During OA, synovitis causes hypoxia [ 47 ], hypercapnia, and acidity in synovial fluid [ 48 ]. In addition, an increase in intra-articular SF volume causes a shift of local metabolism towards anaerobic glycolysis, thus contributing to the decrease of SF glucose levels [ 49 ]. Besides, synovial cavity damages correlates with fluctuating oxygen pressure in the joint, overproduction of free radical and lack of oxygen-processing enzymes and free radical scavenging molecules [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

In vitro and in vivo potentialities for cartilage repair from human advanced knee osteoarthritis synovial fluid-derived mesenchymal stem cells

et al. 2018

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BackgroundMesenchymal stem cells (MSCs) are found in synovial fluid (SF) and can easily be harvested during arthrocentesis or arthroscopy. However, SF-MSC characterization and chondrogenicity in collagen sponges have been poorly documented as well as their hypothetical in vivo chondroprotective properties with intra-articular injections during experimental osteoarthritis (OA).MethodsSF-MSCs were isolated from human SF aspirates in patients suffering from advanced OA undergoing total knee joint replacements. SF-MSCs at passage 2 (P2) were characterized by flow cytometry for epitope profiling. SF-MSCs at P2 were subsequently cultured in vitro to assess their multilineage potentials. To assess their chondrogenicity, SF-MSCs at P4 were seeded in collagen sponges for 4 weeks under various oxygen tensions and growth factors combinations to estimate their gene profile and matrix production. Also, SF-MSCs were injected into the joints in a nude rat anterior cruciate ligament transection (ACLT) to macroscopically and histologically assess their possible chondroprotective properties,.ResultsWe characterized the stemness (CD73+, CD90+, CD105+, CD34−, CD45−) and demonstrated the multilineage potency of SF-MSCs in vitro. Furthermore, the chondrogenic induction (TGF-ß1 ± BMP-2) of these SF-MSCs in collagen sponges demonstrated a good capacity of chondrogenic gene induction and extracellular matrix synthesis. Surprisingly, hypoxia did not enhance matrix synthesis, although it boosted chondrogenic gene expression (ACAN, SOX9, COL2A1). Besides, intra-articular injections of xenogenic SF-MSCs did exert neither chondroprotection nor inflammation in ACLT-induced OA in the rat knee.ConclusionsAdvanced OA SF-MSCs seem better candidates for cell-based constructs conceived for cartilage defects rather than intra-articular injections for diffuse OA.

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Section: Discussionmentioning

confidence: 99%

In vitro and in vivo potentialities for cartilage repair from human advanced knee osteoarthritis synovial fluid-derived mesenchymal stem cells

et al. 2018

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“…High-protein oedema is known to induce moderate chronic inflammation neutrophils. SF volume increase correlates to hypoxia (17,19), and the former seems to be the primary event (17). This is supported by the observation (14) that knee SF volume increase elevates SF hydrostatic pressure, especially during quadriceps contraction and if the joint capsule is fibrotic, as in RA.…”

Section: Possible Early Causes Of Exudation and Joint Effusionmentioning

confidence: 68%

Can increased generalized vascular leakage in ambulant individuals induce joint effusions, synovitis, hypoxia and destruction?

Ahlqvist¹

1983

Scandinavian Journal of Rheumatology

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Ahlqvist J. (Department of Pathology, Aurora Hospital, Helsingfors, Finland.) Can increased generalized vascular leakage in ambulant individuals induce joint effusions, synovitis, hypoxia and destruction? Scand J Rheumatol, Suppl 52: 86-92, 1984.Fundamental points of a hypothesis on the pathogenesis of non-specific synovitides can be summarized as follows: ))Many mechanisms can make blood vessels leaky to fluid and protein. In people in whom some of these mechanisms work, fluid tends to accumulate in and around joints because mechanical stress enhances fluid influx into these structures from which the removal of protein by lymphatics is poor. When joints are used, the pressure in the effusion increases, especially if the surrounding tissue is scarry, disturbing circulation, and swollen tissues containing extra protein tend to become inflamed, and later to die if they do not get enough oxygen from the blood.)) The (combination of) leakage-inducing mechanisms to which patients are hyperresponsive need not be the same in two patients fulfilling the criteria of, e.g., rheumatoid arthritis. It is suggested that the significance of combinations of such ())contributing))) mechanisms should be uprated to give ))multifactorial)) a wider meaning.Discrepancies between existing theories on the pathogenesis of rheumatoid and other nonspecific synovitides, and clinical, laboratory and morphological findings (1, 3) induced me to search for explanations that do not disagree with such findings. The present hypothesis has been dealt with at length elsewhere (3, 4).

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“…It is known that articular effusion causes postoperative inconvenience such as pain; also influences recovery process, tissue repair, range of movement (ROM), muscle activation, clinical evolution and global satisfaction of the procedure [1] [2] [3] [4]. Knee arthroscopy is a minimally invasive procedure in which the whole joint sustains a traumatic process of variable intensity due to penetration of surgical instruments and fluid.…”

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confidence: 99%

Knee Effusion after Arthroscopic Partial Meniscectomy: Prospective Study Comparing Preventing Methods

Pakuts¹,

Martín²

2019

OJO

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Background: Knee joint effusion is a common adverse event after arthroscopic procedures and its prevention is crucial to achieve better clinical outcomes, such as pain relief, improved range of movement and global satisfaction. Objective: The aim of this study is to compare joint effusion after partial arthroscopic meniscectomy between a common postoperative management and a short period in deep flexion. Methods: A prospective study randomizes 62 patients who underwent arthroscopic partial meniscectomy into 2 groups of postoperative care: compression elastic bandage with elevation for 24 hours (compression group) versus immediate postoperative deep flexion for 2 hours (flexion group). Clinical evaluation of effusion was made at 24 hours, 7 days and 1-month post-surgery. Results: Overall at 24 hours patients showed 53% absent effusion, 35% minimum, 11% had mild or more severe effusion. Effusion rates in the compression group were 13%, 10% and 0%; in the flexion group 10%, 6.4% and 0%, at 24 hours, 7 days and 1 month, respectively. There was no statistically significant difference between them (p > 0.05). Conclusion: In the studied population, position of the knee in deep flexion had similar influence in effusion outcomes than a standard widely used treatment, offering an alternative in the postoperative care of the patients.

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Postoperative synovial fluid metabolic response to meniscectomy or synovectomy

Cited by 15 publications

References 11 publications

In vitro and in vivo potentialities for cartilage repair from human advanced knee osteoarthritis synovial fluid-derived mesenchymal stem cells

In vitro and in vivo potentialities for cartilage repair from human advanced knee osteoarthritis synovial fluid-derived mesenchymal stem cells

Can increased generalized vascular leakage in ambulant individuals induce joint effusions, synovitis, hypoxia and destruction?

Knee Effusion after Arthroscopic Partial Meniscectomy: Prospective Study Comparing Preventing Methods

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