Articular cartilage response to arthroscopic surgery: A review of current knowledge

  • John P. Fulkerson
    Address correspondence and reprint requests to Dr. J. P. Fulkerson at University of Connecticut School of Medicine, Farmington, Connecticut 06032, U.S.A.
    Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, U.S.A.
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  • Thomas F. Winters Jr.
    Orthopaedic Surgery, University of Connecticut School of Medicine, Farmington, Connecticut, U.S.A.
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      This review is intended to point out the many variables affecting articular cartilage around the time of arthroscopic surgery. Despite the rapid clinical recovery of arthroscopic surgery patients, there may be considerable articular cartilage inhibition related to preoperative, intraoperative, and postoperative factors. Risks to the patient and his joint can be minimized by careful management of these known variables.
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        • Galasko CSB
        • Rushton S
        • Lacey E
        Prostaglandins and the synovitis associated with meniscal lesions.
        Trans Orthop Res Soc. 1980; 5: 61
        • Thompson Jr, RC
        An experimental study of surface injury to articular cartilage and enzyme responses within the joint.
        Clin Orthop. 1975; 107: 239-248
        • Chrisman OD
        • Ladenbauer-Bellis IM
        • Panjabi M
        The relationship of mechanical trauma and the early biochemical reactions of osteoarthritic cartilage.
        Clin Orthop. 1981; 161: 275-284
        • Steinberg J
        • Sledge CB
        • Noble J
        • Stirrat CR
        A tissue culture model of cartilage breakdown in rheumatoid arthritis.
        Biochem J. 1979; 180: 403-412
        • Fulkerson JP
        • Damiano P
        Effect of prostaglandin E2 on adult pig articular cartilage slices in culture.
        Clin Orthop. 1983; 179: 266-269
        • Fulkerson JP
        • Ladenbauer-Bellis I-M
        • Chrisman OD
        In vitro hexosamine depletion of intact articular cartilage by E prostaglandins.
        Arthritis Rheum. 1979; 22: 1117-1121
        • Houston JP
        • McGuire MKB
        • Meats JE
        • et al.
        Adenylate cyclase of human articular chondrocytes.
        Biochem J. 1982; 208: 35-42
        • Malemud CJ
        • Moskowitz RW
        • Papay RS
        Correlation of the biosynthesis of prostaglandin and cyclic AMP in monolayer cultures of rabbit articular chondrocytes.
        Biochem Biophys Acta. 1982; 715: 70-79
        • Palmoski MJ
        • Brandt KD
        Effects of salicylate and indomethacin on glycosaminoglycan and prostaglandin E2 synthesis in intact canine knee cartilage ex vivo.
        Arthritis Rheum. 1984; 27: 398-403
        • Vane JR
        Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs.
        Nature (New Biol). 1971; 231: 232-235
        • Palmoski MJ
        • Brandt KD
        Benoxaprofen stimulate, proteoglycan synthesis in normal canine knee cartilage in vitro.
        Arthritis Rheum. 1983; 26: 771-774
        • McKenzie LS
        • Horsburgh BA
        • Ghosh P
        • Taylor TKF
        Effects of anti-inflammatory drugs on sulfated glycosaminoglycan synthesis in aged human articular cartilage.
        Ann Rheum Dis. 1976; 35: 487-497
        • Palmoski MJ
        • Brandt KD
        Effects of some nonsteroidal anti-inflammatory drugs on proteoglycan metabolism and organization in canine articular cartilage.
        Arthritis Rheum. 1980; 23: 1010-1020
        • Watson M
        The suppression effect of indomethacin on articular cartilage.
        Rheumatol Rehabil. 1976; 15: 25-30
        • Farkas T
        • Lippiello L
        • Mitrovic D
        • Schachar NS
        • Trahan C
        • Mankin HJ
        Papain-induced healing of superficial lacerations in articular cartilage of adult rabbits.
        Trans Orthop Res Soc. 1977; 2: 204
        • Hoaglund FT
        Experimental hemarthrosis: the response of canine knees to injections of autologous blood.
        J Bone Joint Surg. 1967; 49A: 285-298
        • Stein H
        • Duthie RB
        The pathogenesis of chronic haemophilic arthropathy.
        J Bone Joint Surg. 1981; 63B: 601-609
        • Sokoloff L
        Biochemical and physiological aspects of degenerative joint diseases with special reference to hemophilic arthropathy.
        Ann NY Acad Sci. 1975; 240: 285-290
        • Soeur R
        The synovial membrane of the knee in pathological conditions.
        J Bone Joint Surg. 1949; 31A: 317-340
        • Hamilton E
        • Williams R
        • Barlow KA
        • Smith PM
        The arthropathy of idiopathic haemochromatosis.
        Q J Med. 1968; 37: 171-182
        • Jaffe A
        Ueber die veranderungen der synovialmembran bei beruhrung mit blut.
        Arch Klin Chir. 1897; 54: 69-97
        • Sigurdson LA
        The structure and function of articular synovial membranes.
        J Bone Joint Surg. 1930; 12A: 603-639
        • Enneking WF
        • Horowitz M
        The intra-articular effects of immobilization on the human knee.
        J Bone Joint Surg. 1972; 54A: 973-985
        • Finsterbush A
        • Friedman B
        Early changes in immobilized rabbit knee joints: a light and electron microscopic study.
        Clin Orthop. 1975; 92: 305-319
        • Langenskiold A
        • Michelsson J-E
        • Videman T
        Osteoarthritis of the knee in the rabbit produced by immobilization.
        Acta Orthop Scand. 1979; 50: 1-14
        • Trojer H
        The effect of short-term immobilization on the rabbit knee joint cartilage.
        Clin Orthop. 1975; 107: 249-257
        • Palmoski MJ
        • Brandt KD
        Immobilization of the knee prevents osteoarthritis after anterior cruciate ligament transection.
        Arthritis Rheum. 1982; 25: 1201-1208
        • Williams JM
        • Brandt KD
        Immobilization ameliorates chemically induced articular cartilage damage.
        Arthritis Rheum. 1984; 27: 208-216
        • Palmoski MJ
        • Perricone E
        • Brandt KD
        Development and reversal of a proteoglycan aggregation defect in normal canine knee cartilage after immobilization.
        Arthritis Rheum. 1979; 22: 508-517
        • Radin E
        • Brandt KD
        Cartilage and joint physiology II. Joint and cartilage mechanics.
        in: A.A.O.S. Instructional Course 203. A.A.O.S. Annual Meeting, Las Vegas, Nevada1985
        • Reagan BF
        • McIneray VK
        • Treadwell BV
        • Zarins B
        • Mankin HJ
        Irrigating solutions for arthroscopy.
        J Bone Joint Surg. 1983; 65A: 629-631
        • Nole R
        • Munson N
        • Fulkerson JP
        Bupivacaine and saline effects on articular cartilage.
        Arthros Rel Surg. 1985; 1: 123-127
        • George RC
        • Chrisman OD
        The role of cartilage polysaccharides in osteoarthritis.
        Clin Orthop. 1968; 57: 259-265
        • Mankin HJ
        The response of articular cartilage to mechanical injury.
        J Bone Joint Surg. 1982; 64A: 460-466
        • Meachim G
        The effects of scarification on articular cartilage in the rabbit.
        J Bone Joint Surg. 1963; 45B: 150-161
        • Fuller JA
        • Ghadially FN
        Ultrastructural observations on surgically produced partial-thickness defects in articular cartilage.
        Clin Orthop. 1972; 86: 193-205
        • Ghadially FN
        • Thomas I
        • Oryschak AF
        • LaLonde J-M
        Long-term results of superficial defects in articular cartilage. A scanning electron microscope study.
        J Pathol. 1977; 121: 213-217
        • Meachim G
        • Roberts C
        Repair of the joint surface from subarticular tissue in the rabbit knee.
        J Anat. 1971; 109: 317-327
        • Mitchell N
        • Shepard N
        The resurfacing of adult rabbit articular cartilage by multiple perforations through the subchondral bone.
        J Bone Joint Surg. 1976; 58A: 230-233
        • Furukawa T
        • Eyre DR
        • Koide S
        • Glimcher MJ
        Biochemical studies on repair cartilage resurfacing experimental defects in the rabbit knee.
        J Bone Joint Surg. 1980; 62A: 79-89
        • Convery FR
        • Akeson WH
        • Keown GM
        The repair of large osteochondral defects. An experimental study in horses.
        Clin Orthop. 1972; 82: 253-262
        • Baker B
        • Becker RO
        • Spadaro J
        A study of electrochemical enhancement of articular cartilage repair.
        Clin Orthop. 1974; 102: 251-267
        • Salter RB
        • Simmonds DF
        • Malcolm BW
        • Rumble EJ
        • MacMichael D
        • Clements ND
        The biological effects of continuous passive motion on the healing of full-thickness defects in articular cartilage.
        J Bone Joint Surg. 1980; 62A: 1232-1251
        • Friedman MJ
        • Berasi CC
        • Fox JM
        • Del Pizzo W
        • Snyder SJ
        • Ferkel RD
        Preliminary results with abrasion arthroplasty in the osteoarthritic knee.
        Clin Orthop. 1984; 182: 200-205
        • Krompinger WJ
        • Fulkerson JP
        Lateral retinacular release for intractable lateral retinacular pain.
        Clin Orthop. 1983; 179: 191-193
        • McGinty JB
        • McCarthy JC
        Endoscopic lateral retinacular release: a preliminary report.
        Clin Orthop. 1981; 158: 120-125
        • Metcalf RW
        An arthroscopic method for lateral release of the subluxating or dislocating patella.
        Clin Orthop. 1982; 167: 9-18
      1. Schmidt RF Fundamentals of sensory physiology. Springer-Verlag, New York1981: 95-101
        • Hall-Craggs ECB
        Survival of statellite cells following exposure to the local anesthetic bupivacaine (Marcaine).
        Cell Tissue Res. 1980; 209: 131-135
        • Goodman LS
        • Gilman A
        The pharmacological basis of therapeutics.
        Macmillan Inc., New York1965
        • Mankin HJ
        • Conger KA
        The acute effects of intra-articular hydrocortisone on articular cartilage in rabbits.
        J Bone Joint Surg. 1966; 48A: 1383-1388
        • Behrens F
        • Shepard N
        • Mitchell N
        Alteration of rabbit articular cartilage by intra-articular injections of glucocorticoids.
        J Bone Joint Surg. 1975; 57A: 70-76
        • Ogilvie-Harris DJ
        • Bauer M
        • Corey P
        Prostaglandin inhibition and the rate of recovery after arthroscopic menisectomy.
        J Bone Joint Surg. 1985; 67B: 567-571
        • Colletti JM
        • Akeson WH
        • Woo SLY
        A comparison of the physical behavior of normal articular cartilage and the arthroplasty surface.
        J Bone Joint Surg. 1972; 54A: 147-160