Purpose
The purpose of this study was to evaluate the effect on cell viability of the isolated
and combined use of allogeneic platelet-rich plasma (PRP) and ketorolac tromethamine
on human chondrocytes and tenocytes in a highly controlled in vitro environment.
Methods
PRP was produced from 8 subjects. Human chondrocytes (Lonza, Hopkinton, MA) and tenocytes
isolated from samples of the long head of the biceps tendons were treated in culture
with PRP, ketorolac tromethamine, and methylprednisolone, both alone and in combination.
Control samples were treated in media containing 2% or 10% fetal bovine serum (FBS).
Cells were exposed for 1 hour. Luminescence assays were obtained to examine cell viability
after 24 hours and long-term effects on cell viability after 120 hours. Radioactive
thymidine assay was used to measure proliferation after 120 hours.
Results
For chondrocytes, cell viability (120 hours) increased significantly with the treatment
of PRP alone (43,949 ± 28,104 cells; P < .001) and with the combination of ketorolac tromethamine and PRP (43,276 ± 31,208;
P < .001), compared with the 2% FBS group (7,397 ± 470). Cell viability decreased significantly
after exposure to methylprednisolone (1,323 ± 776; P < .001) and its combination with PRP (4,381 ± 5,116; p < .001). For tenocytes, cell viability (120 hours) was significantly higher with
the treatment of PRP (61,287 ± 23,273; P < .001) and the combined treatment of ketorolac tromethamine and PRP (52,025 ± 17,307;
P < .001), compared with the 2% FBS group (23,042 ± 2,973). Cell viability decreased
significantly after exposure to methylprednisolone (3,934 ± 1,791; P = .001) and its combination with PRP (5,201 ± 2,834; P = .003), compared with 2% FBS.
Conclusions
Tendon and cartilage cells showed increased cell viability after an exposure to allogeneic
PRP and ketorolac tromethamine. Exposure to methylprednisolone alone decreased cell
viability, and addition of PRP could partially reverse this negative effect.
Clinical Relevance
Intra-articular injections of pain-modifying or anti-inflammatory drugs are routinely
given in orthopaedic practice. Among the many agents available for intra-articular
injection, corticosteroids and local anesthetics are the most common in clinical practice.
Potential detrimental side effects of intra-articular injections of corticosteroids
and local anesthetics have prompted investigation into alternative treatment options
such as combinations of PRP and ketorolac tromethamine. In vitro evaluation of their
effect on cell viability might build a basis for further translational research and
clinical application.
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Article info
Publication history
Accepted:
April 12,
2013
Received:
October 7,
2011
Footnotes
The University of Connecticut Health Center/New England Musculoskeletal Institute has received direct funding and material support for this study from Arthrex, Naples, FL. The company had no influence on study design, data collection, or interpretation of the results or the final manuscript.
The authors report the following potential conflict of interest or source of funding in relation to this article: A.D.M. received a grant from Arthex; A.D.M. received a research grant to support salary and research from Arthrex; A.A.R. receives research support from Arthrex, Ossur, and Smith & Nephew, receives royalties and is a consultant for Arthrex, and is a paid speaker for Arthrex and DJ Orthopaedics; J.B. receives research support and royalties from Arthrex; and N.S.E. receives royalties for consulting from Arthrex.
Identification
Copyright
© 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
