Riggin Corinne N, Tucker Jennica J, Soslowsky Louis J, Kuntz Andrew F
McKay Orthopaedic Laboratory, University of Pennsylvania, 424 Stemmler Hall, 36th Street & Hamilton Walk, Philadelphia, Pennsylvania, 19104.
J Orthop Res. 2014 Nov;32(11):1512-9. doi: 10.1002/jor.22674. Epub 2014 Jul 1.
Administration of intra-articular medications, including corticosteroids and analgesics, is common clinical practice for knee pathology and dysfunction. Non-steroidal anti-inflammatory drugs (NSAIDs) are another category of medication commonly prescribed for their analgesic and anti-inflammatory properties. Recent studies demonstrated the efficacy of injectable NSAIDs in the treatment of intra-articular pathology and postoperative analgesia. However, little data exist regarding the safety of intra-articular injection, despite the increase in its application. Therefore, we investigated the effects of intra-articular NSAID injection on articular cartilage, the anterior cruciate ligament (ACL), and joint function in the rat. Sixty-four Sprague-Dawley rats were divided into either saline (SAL) or ketorolac (NSAID) tibiofemoral single injection treatment groups. Animals were euthanized at 2, 7, 28, and 84 days post-injection for histological and mechanical analyses. Additionally, a subset of animals underwent longitudinal ambulatory evaluation to determine joint functional properties. We hypothesized that intra-articular ketorolac injection would result in no detrimental mechanical, histological, or functional changes. No differences were reported between the NSAID and SAL groups in any of the parameters measured at any time point, demonstrating the potential safety of intra-articular NSAID administration. Therefore, NSAID injection could be further considered for clinical application in humans.
关节内注射药物,包括皮质类固醇和镇痛药,是治疗膝关节病变和功能障碍的常见临床操作。非甾体抗炎药(NSAIDs)是另一类因其镇痛和抗炎特性而常用的药物。最近的研究表明,注射用NSAIDs在治疗关节内病变和术后镇痛方面具有疗效。然而,尽管关节内注射的应用有所增加,但关于其安全性的数据却很少。因此,我们研究了关节内注射NSAIDs对大鼠关节软骨、前交叉韧带(ACL)和关节功能的影响。将64只Sprague-Dawley大鼠分为生理盐水(SAL)或酮咯酸(NSAID)胫股单注射治疗组。在注射后2天、7天、28天和84天对动物实施安乐死,进行组织学和力学分析。此外,对一部分动物进行纵向动态评估,以确定关节功能特性。我们假设关节内注射酮咯酸不会导致有害的力学、组织学或功能变化。在任何时间点测量的任何参数上,NSAID组和SAL组之间均未报告差异,这表明关节内注射NSAIDs具有潜在安全性。因此,NSAID注射可进一步考虑用于人类的临床应用。