Purpose
This study was designed to evaluate differences in proinflammatory and degradative
mediator production and extracellular matrix degradation from osteoarthritic knee
articular cartilage and meniscus explants treated with either hyperosmolar saline
or isotonic saline.
Methods
6 mm-diameter full-thickness explants were created from articular cartilage and menisci
recovered after patients underwent knee surgery. One explant half was treated for
3 hours with hyperosmolar saline (600 mOsm/L) and the corresponding half with isotonic
saline (300 mOsm/L). Explants were subsequently cultured for 3 days in tissue culture
media. On day 3, media were collected for biomarker analyses. Results were normalized
to tissue wet weight and analyzed statistically.
Results
Articular cartilage was collected from 10 patients (5 male, 5 female; mean age = 66.9
years) and menisci were collected from 8 patients (2 male, 6 female; mean age = 66
years). Articular cartilage media concentrations of monocyte chemoattractant protein-1
(
P = .001) and interleukin (IL)-6 (
P = .049) were significantly lower in explants treated with hyperosmolar saline. Meniscus
media concentrations of prostaglandin E
2 (
P = .008), monocyte chemoattractant protein-1 (
P = .011), IL-6 (
P = .029), IL-8 (
P = .012), matrix metalloproteinase-2 (
P = .011), and glycosaminoglycan (
P = .008) were significantly lower in explants treated with hyperosmolar saline.
Conclusions
Treatment of cartilage and meniscus explants with hyperosmolar saline effectively
mitigated key proinflammatory mediator production, as well as degradative mediator
production and glycosaminoglycan loss from meniscus, with no detrimental effects noted
compared to isotonic saline.
Clinical Relevance
These results suggest that hyperosmolar saline irrigation fluid may provide a safe
alternative to standard isotonic saline irrigation fluid, and could mitigate untoward
effects associated with inflammatory responses after standard-of-care knee arthroscopy.
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Article Info
Publication History
Published online: July 18, 2020
Accepted:
July 12,
2020
Received:
January 23,
2020
Footnotes
The authors report the following potential conflicts of interest or sources of funding: A.M.S. reports personal fees and other from Arthrex , personal fees from Musculoskeletal Transplant Foundation , and other from DePuy Synthes, outside the submitted work. J.P.S. reports other from the American Orthopaedic Association , other from the AO Foundation , other from AO North America , grants and personal fees from Arthrex , grants from Coulter Foundation, personal fees from DePuy Synthes, other from Journal of Knee Surgery, other from Mid-America Orthopaedic Association, grants from National Institutes of Health ( NIAMS & NICHD ), personal fees from Orthopedic Designs North America, personal fees from Smith & Nephew, other from Thieme, and grants from U.S. Department of Defense , outside the submitted work. J.L.C. reports personal fees from Artelon, grants and personal fees from Arthrex , personal fees from AthleteIQ, grants from ConforMIS, personal fees from CONMED Linvatec, grants from the Coulter Foundation, grants from DePuy Synthes, grants and personal fees from Eli Lilly , other from Journal of Knee Surgery, grants from Merial, other from Midwest Transplant Network, grants, personal fees, and other from Musculoskeletal Transplant Network, grants from National Institutes of Health ( NIAMS & NICHD ), grants from Purina, personal fees from Schwartz Biomedical, personal fees and other from Thieme, personal fees from Trupanion, grants from U.S. Department of Defense , and grants from Zimmer- Biomet , outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2020 by the Arthroscopy Association of North America
