Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.; Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, U.S.A.
Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, U.S.A.; Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri, U.S.A..
Arthroscopy. 2020 Dec;36(12):3050-3057. doi: 10.1016/j.arthro.2020.07.017. Epub 2020 Jul 18.
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.
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.
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 (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.
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.
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.
本研究旨在评估用高渗盐水或等渗盐水处理骨关节炎膝关节关节软骨和半月板的植入物后，促炎和降解介质的产生以及细胞外基质降解的差异。
从患者膝关节手术后回收的关节软骨和半月板中切取 6mm 直径的全层植入物。将一半植入物用高渗盐水（600mOsm/L）处理 3 小时，另一半用等渗盐水（300mOsm/L）处理。然后将植入物在组织培养基中培养 3 天。第 3 天，收集培养基进行生物标志物分析。结果以组织湿重为基准进行标准化，并进行统计学分析。
共收集 10 名患者（5 名男性，5 名女性；平均年龄 66.9 岁）的关节软骨和 8 名患者（2 名男性，6 名女性；平均年龄 66 岁）的半月板。用高渗盐水处理的关节软骨培养基中单核细胞趋化蛋白-1（MCP-1）（P=.001）和白细胞介素-6（IL-6）（P=.049）的浓度明显较低。用高渗盐水处理的半月板培养基中前列腺素 E（PGE）（P=.008）、单核细胞趋化蛋白-1（MCP-1）（P=.011）、白细胞介素-6（IL-6）（P=.029）、白细胞介素-8（IL-8）（P=.012）、基质金属蛋白酶-2（MMP-2）（P=.011）和糖胺聚糖（GAG）（P=.008）的浓度明显较低。
用高渗盐水处理软骨和半月板植入物可有效减轻关键促炎介质的产生，以及半月板中降解介质的产生和糖胺聚糖的丢失，与等渗盐水相比，未见有害影响。
这些结果表明，高渗盐水灌洗液可能是标准等渗盐水灌洗液的安全替代物，并可能减轻标准膝关节镜检查后炎症反应相关的不良影响。
