Document Detail

Effect of Different Irrigation Fluids on Human Articular Cartilage: An In Vitro Study.
MedLine Citation:
PMID:  23265689     Owner:  NLM     Status:  Publisher    
PURPOSE: The goal of this study was to examine the effect of different irrigation fluids on human articular cartilage. METHODS: Femoral heads were obtained from 9 patients with fractured neck of femur (mean age, 89 years; 7 female) and tibial plateaus from 2 female patients at the time of total knee replacement (mean age, 73 years). Chrondral explants were harvested and exposed to 1 of 4 different irrigation fluids for 1 hour: Ringer's solution, normal saline (0.9% NaCl), 1.5% glycine, or 5% mannitol. M199 culture medium was used as a positive control, and 0.5% bupivicaine, previously shown to be harmful to articular cartilage, as a negative control. After exposure, explants were incubated with radiolabeled sulfate ((35)S0(4)), and uptake was measured after 16 hours as an indicator of proteoglycan synthesis. RESULTS: (35)S0(4) uptake was inhibited 10% by Ringer's solution (P = .3), 24% by 1.5% glycine (P = .08), 31% by 5% mannitol (P = .03), 35% by normal saline (P = .04), and 90% by 0.5% bupivacaine (P < .001), compared with the M199 control. Comparisons of the different solutions showed that all solutions were less inhibitory than 0.5% bupivacaine (P < .001). The only significant difference was that between normal saline and Ringer's solution (P = .03). CONCLUSIONS: In an in vitro model of human articular cartilage, Ringer's solution had the least effect on cartilage metabolism, and normal saline caused the greatest inhibition of cartilage metabolism. CLINICAL RELEVANCE: Normal saline, the most commonly used irrigation fluid, may have an inhibitory effect on proteoglycan metabolism in articular cartilage. Additional studies are required to assess the potential damage to cartilage from normal saline in the clinical setting.
Abhinav Gulihar; David J Bryson; Grahame J S Taylor
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-19
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  -     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Department of Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, England. Electronic address:
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