Department of Orthopedic Surgery, Acibadem Kadikoy Hospital, Acibadem University Faculty of Medicine, Istanbul, Turkey.
Orthopaedics and Traumatology Department, Acibadem University Faculty of Medicine, Istanbul, Turkey.
Knee Surg Sports Traumatol Arthrosc. 2019 Mar;27(3):936-941. doi: 10.1007/s00167-017-4796-z. Epub 2017 Dec 2.
The aim of this study was to evaluate the effect of Ringer's lactate (RL) solutions with different pH values on early histologic healing in a microfracture model in vivo. The null hypothesis of the presented study is that irrigation fluids with lower pH (6.4) have negative effects on fibrous cartilage healing.
Eighteen Wistar albino rats were randomly divided into three groups. Anterior midline incision was performed. Microfracture procedure was performed with a 1.2 mm k-wire at the lateral femoral condyle of each knee. the skin was sutured and joints were irrigated for 30 min with low pH (6.4) RL in Group 1, high pH (7.6) RL in Group 2 and no irrigation in Group 3. Three rats from each group were randomly selected and killed on the 3rd and 7th day. On the 3rd day, the healed chondral area was examined. On the 3rd and 7th day, the chondral depth and morphology were evaluated. On the 7th day, bone cellularity was assessed with osteoblast; osteoclast number and bone quality were evaluated with trabecular area and the number of trabeculae.
Chondral healing area on the 3rd day was significantly higher in Group 1 compared to other groups. Chondral morphology was also qualitatively superior in Group 1 compared to other groups on the 3rd and 7th day. There were no differences in chondral depths between the groups on the 3rd day; however, increased chondral depths were observed in Group 1 on the 7th day. There were statistically significant increases in trabecular area and the number of trabeculae, as well as the number of osteoblasts and osteoclasts in Group 1 on the 7th day.
The presented study revealed that low pH irrigation fluids have positive effects on the healing characteristics of intra-articular fibrous cartilage after microfracture procedure in vivo. In light of this study, we can assume that lower pH solutions could be safely used during microfracture procedures and it can also facilitate intra-articular fibrous cartilage formation and cartilage healing. Selection of irrigation solution is also important for intra-articular fibrous cartilage healing after microfracture procedure in vivo.
本研究旨在评估不同 pH 值的林格氏乳酸盐（RL）溶液对体内微骨折模型早期组织学愈合的影响。本研究的零假设是，pH 值较低（6.4）的冲洗液对纤维软骨愈合有负面影响。
将 18 只 Wistar 白化大鼠随机分为三组。在每个膝关节的外侧股骨髁上进行前中线切口。用 1.2mm 的 K 线在每个膝关节上进行微骨折手术。皮肤缝合后，用低 pH 值（6.4）RL 在第 1 组、高 pH 值（7.6）RL 在第 2 组和不冲洗在第 3 组中冲洗 30 分钟。每组随机选择 3 只大鼠，并于第 3 天和第 7 天处死。第 3 天，检查愈合的软骨区域。第 3 天和第 7 天，评估软骨深度和形态。第 7 天，通过成骨细胞评估骨细胞密度；通过骨小梁面积和骨小梁数量评估破骨细胞数量和骨质量。
第 3 天，第 1 组的软骨愈合面积明显高于其他组。第 3 天和第 7 天，第 1 组的软骨形态也明显优于其他组。第 3 天，各组软骨深度无差异；然而，第 7 天，第 1 组的软骨深度增加。第 7 天，第 1 组的骨小梁面积和数量以及成骨细胞和破骨细胞数量均显著增加。
本研究表明，低 pH 值冲洗液对体内微骨折术后关节内纤维软骨的愈合特性有积极影响。鉴于本研究，我们可以假设，在微骨折手术过程中，可以安全地使用较低 pH 值的溶液，这也可以促进关节内纤维软骨的形成和软骨愈合。选择冲洗液对于体内微骨折术后关节内纤维软骨的愈合也很重要。
