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通过提高冲洗液的温度和渗透压对软骨损伤模型进行软骨保护

Chondroprotection in Models of Cartilage Injury by Raising the Temperature and Osmolarity of Irrigation Solutions.

作者信息

Eltawil Noha M, Ahmed Saima, Chan Luke H, Simpson A Hamish R W, Hall Andrew C

机构信息

1 Centre for Integrative Physiology, Deanery of Biomedical Sciences, University of Edinburgh, Edinburgh, UK.

2 Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh and University of Edinburgh, 49 Little France Crescent, Edinburgh, UK.

出版信息

Cartilage. 2018 Jul;9(3):313-320. doi: 10.1177/1947603516688511. Epub 2017 Jan 30.

Abstract

Objectives During arthroscopic or open joint surgery, articular cartilage may be subjected to mechanical insults by accident or design. These may lead to chondrocyte death, cartilage breakdown and posttraumatic osteoarthritis. We have shown that increasing osmolarity of routinely used normal saline protected chondrocytes against injuries that may occur during orthopedic surgery. Often several liters of irrigation fluid are used during an orthopedic procedure, which is usually kept at room temperature, but is sometimes chilled. Here, we compared the effect of normal and hyperosmolar saline solution at different temperatures on chondrocyte viability following cartilage injury using in vitro and in vivo models of scalpel-induced injury. Design Cartilage injury was induced in bovine osteochondral explants and the patellar groove of rats in vivo by a single pass of a scalpel blade in the presence of normal saline (300 mOsm) or hyperosmolar saline solution (600 mOsm, sucrose addition) at 4°C, 21°C, or 37°C. Chondrocytes were fluorescently labeled and visualized by confocal microscopy to assess cell death. Results Hyperosmolar saline reduced scalpel-induced chondrocyte death in both bovine and rat cartilage by ~50% at all temperatures studied (4°C, 21°C, 37°C; P < 0.05). Raising temperature of both irrigation solutions to 37°C reduced scalpel-induced cell death ( P < 0.05). Conclusions Increasing the osmolarity of normal saline and raising the temperature of the irrigation solutions to 37°C reduced chondrocyte death associated with scalpel-induced injury in both in vitro and in vivo cartilage injury models. A hyperosmolar saline irrigation solution at 37°C may protect cartilage by decreasing the risk of chondrocyte death during mechanical injury.

摘要

目的 在关节镜手术或开放性关节手术过程中,关节软骨可能会因意外或有意操作而受到机械损伤。这些损伤可能导致软骨细胞死亡、软骨破坏以及创伤后骨关节炎。我们已经表明,提高常规使用的生理盐水的渗透压可保护软骨细胞免受骨科手术期间可能发生的损伤。在骨科手术过程中通常会使用数升冲洗液,冲洗液通常保持在室温,但有时会冷却。在此,我们使用手术刀诱导损伤的体外和体内模型,比较了不同温度下的等渗和高渗盐溶液对软骨损伤后软骨细胞活力的影响。

设计 在4℃、21℃或37℃下,在存在生理盐水(300 mOsm)或高渗盐溶液(600 mOsm,添加蔗糖)的情况下,用手术刀单次切割诱导牛骨软骨外植体和大鼠髌沟的软骨损伤。对软骨细胞进行荧光标记,并通过共聚焦显微镜观察以评估细胞死亡情况。

结果 在所有研究温度(4℃、21℃、37℃)下,高渗盐溶液使牛和大鼠软骨中手术刀诱导的软骨细胞死亡减少了约50%(P < 0.05)。将两种冲洗液的温度提高到37℃可减少手术刀诱导的细胞死亡(P < 0.05)。

结论 在体外和体内软骨损伤模型中,提高生理盐水的渗透压并将冲洗液温度提高到37℃可减少与手术刀诱导损伤相关的软骨细胞死亡。37℃的高渗盐溶液冲洗液可能通过降低机械损伤期间软骨细胞死亡的风险来保护软骨。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65e3/6042036/bdc125232564/10.1177_1947603516688511-fig1.jpg

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