Purpose: The aim of this study was to study local synovial metabolism and inflammation after
arthroscopy and arthroscopic anterior cruciate ligament (ACL) reconstruction. Methods: Microdialysis in the synovial membrane was performed during 4 hours postoperatively
in 20 patients undergoing a minor arthroscopy procedure (e.g., meniscus surgery and
10 patients undergoing ACL reconstruction with a quadruple hamstring graft). Contralateral
thigh adipose tissue served as a reference. Lactate, glucose, glycerol, and prostaglandin
E2 (PGE2) were monitored. The ACL group received intra-articular morphine preoperatively,
and a cooling and compression device was applied postoperatively according to local
clinical routines. Results: The synovial lactate levels and the consumption of synovial glucose was increased
postoperatively in the arthroscopy group compared to the reference adipose tissue.
There were no significant differences regarding synovial levels of glycerol, lactate,
or glucose compared to the reference tissue in the ACL group. PGE2 levels were significantly lower in the ACL group compared to the arthroscopy group.
Conclusions: A major arthroscopic surgical procedure (ACL reconstruction) did not increase the
local synovial metabolism or induce a detectable inflammatory response compared to
a minor arthroscopic surgical procedure (e.g., meniscal surgery) in our clinical setting.
Intra-articular injection of morphine and or the use of a combined cooling and compression
device in the ACL group showed a modulation of the response in tissue chemistry as
measured by synovial microdialysis. Level of Evidence: Level III, therapeutic case-control study.
Key Words
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Article info
Publication history
Published online: February 18, 2008
Footnotes
Supported by research grants from Stockholm County and Karolinska Institutet. The authors have no conflict of interest to report.
Identification
Copyright
© 2008 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
