The effect of environmental pH change on bovine articular cartilage metabolism: implications for the use of buffered solution during arthroscopy?

Akgün, Umut; Kocaoğlu, Barış; Ergün, Selim; Karahan, Mustafa; Türkmen, Metin

doi:10.1007/s00167-013-2441-z

Cited by 8 publications

(14 citation statements)

References 18 publications

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“…1 They showed synovial fluid to have a pH of 7.7, a value higher than even blood pH. 1,51 The studies examining pH in this review demonstrated that having a pH close to physiological pH would be ideal 13,27 ; however, it is evident that other properties/factors, such as a solution's ionic make-up, may trump the importance of pH and these other factors would then have to be considered in addition to the solution's pH. A further consideration would be the question of whether a more basic or a more acidic pH would result in greater damage to articular cartilage and should be examined in future studies.…”

Section: Ph Valuesmentioning

confidence: 84%

“…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%

“…Two of the sixteen studies included in this review compared solutions with differing pH levels. 13,27 Reagan et al demonstrated mixed results. Although phosphate-buffered saline initially showed a rise in incorporation of 35 SO 4 (increased metabolic activity), these increments ultimately fell and Ringer's lactate (pH = 6.3) and Ringer's acetate (pH = 6.3) were superior to both normal saline (pH = 5.3) and phosphate buffered saline (pH = 7.1) in supporting metabolic activity.…”

Section: Influence Of Phmentioning

confidence: 99%

“…13 The study by Akgun et al found that exposure to solutions that are either acidic or basic affect chondrocyte activity, with even a difference of 0.2 unit from normal pH resulting in suppression of RNA synthesis and chondrocyte metabolism. 27 Both studies concluded on the importance of utilizing the more physiological solutions for arthroscopic procedures. 13,27…”

Section: Influence Of Phmentioning

confidence: 99%

“…27 Both studies concluded on the importance of utilizing the more physiological solutions for arthroscopic procedures. 13,27…”

Section: Influence Of Phmentioning

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: Ph Valuesmentioning

confidence: 84%

Section: Resultsmentioning

confidence: 99%

Section: Influence Of Phmentioning

confidence: 99%

Section: Influence Of Phmentioning

confidence: 99%

“…27 Both studies concluded on the importance of utilizing the more physiological solutions for arthroscopic procedures. 13,27…”

Section: Influence Of Phmentioning

confidence: 99%

See 3 more Smart Citations

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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Low pH irrigation fluids have positive effect on intra-articular chondral healing

Ülkü

Kocaoğlu

Gereli

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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The presented study revealed that low pH irrigation fluids have positive effects on the healing characteristics of intra-articular fibrous cartilage after microfracture procedure in vivo. In light of this study, we can assume that lower pH solutions could be safely used during microfracture procedures and it can also facilitate intra-articular fibrous cartilage formation and cartilage healing. Selection of irrigation solution is also important for intra-articular fibrous cartilage healing after microfracture procedure in vivo.

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Delivering Microrobots in the Musculoskeletal System

Cao,

Sheng,

Sun

et al. 2024

Nano-Micro Lett.

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Disorders of the musculoskeletal system are the major contributors to the global burden of disease and current treatments show limited efficacy. Patients often suffer chronic pain and might eventually have to undergo end-stage surgery. Therefore, future treatments should focus on early detection and intervention of regional lesions. Microrobots have been gradually used in organisms due to their advantages of intelligent, precise and minimally invasive targeted delivery. Through the combination of control and imaging systems, microrobots with good biosafety can be delivered to the desired area for treatment. In the musculoskeletal system, microrobots are mainly utilized to transport stem cells/drugs or to remove hazardous substances from the body. Compared to traditional biomaterial and tissue engineering strategies, active motion improves the efficiency and penetration of local targeting of cells/drugs. This review discusses the frontier applications of microrobotic systems in different tissues of the musculoskeletal system. We summarize the challenges and barriers that hinder clinical translation by evaluating the characteristics of different microrobots and finally point out the future direction of microrobots in the musculoskeletal system.

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The effect of environmental pH change on bovine articular cartilage metabolism: implications for the use of buffered solution during arthroscopy?

Abstract: II.

Cited by 8 publications

References 18 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

Low pH irrigation fluids have positive effect on intra-articular chondral healing

Delivering Microrobots in the Musculoskeletal System

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