Hyperosmolar irrigation compared with a standard solution in a canine shoulder arthroscopy model
Background A hyperosmolar irrigation solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar irrigation solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy st...
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| Veröffentlicht in: | Journal of shoulder and elbow surgery 2015-08, Vol.24 (8), p.1243-1248 |
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| container_title | Journal of shoulder and elbow surgery |
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| creator | Capito, Nicholas M., MD Smith, Matthew J., MD Stoker, Aaron M., PhD Werner, Nikki Cook, James L., DVM, PhD |
| description | Background A hyperosmolar irrigation solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar irrigation solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study. Methods We designed a translational animal model study in which hyperosmolar arthroscopy irrigation fluid (1.8%, 600 mOsm/L) was compared with normal saline (0.9%, 300 mOsm/L). Purpose-bred research dogs (n = 5) underwent bilateral shoulder arthroscopy. Irrigation fluid was delivered to each shoulder joint (n = 10) at 40 mm Hg for 120 minutes using standard ingress and egress portals. The percentage change in shoulder girth was documented at the completion of 120 minutes. Articular cartilage sections from the glenoid and humeral head were harvested from both shoulders. Chondrocyte viability and tissue water content were evaluated. Differences between groups and compared with time 0 controls were determined, with significance set at P |
| doi_str_mv | 10.1016/j.jse.2014.12.027 |
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Demonstrating the safety of a hyperosmolar irrigation solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study. Methods We designed a translational animal model study in which hyperosmolar arthroscopy irrigation fluid (1.8%, 600 mOsm/L) was compared with normal saline (0.9%, 300 mOsm/L). Purpose-bred research dogs (n = 5) underwent bilateral shoulder arthroscopy. Irrigation fluid was delivered to each shoulder joint (n = 10) at 40 mm Hg for 120 minutes using standard ingress and egress portals. The percentage change in shoulder girth was documented at the completion of 120 minutes. Articular cartilage sections from the glenoid and humeral head were harvested from both shoulders. Chondrocyte viability and tissue water content were evaluated. Differences between groups and compared with time 0 controls were determined, with significance set at P <.05. Results The mean percentage change in shoulder girth was higher in the isotonic control group (13.3%) than in the hyperosmolar group (10.4%). Chondrocyte viability and tissue water content for glenoid and humeral head cartilage were well maintained in both treatment groups, and differences were not statistically significant. Conclusions The data from this study suggest that doubling the osmolarity of the standard irrigation solution used for arthroscopy was not associated with any detrimental effects on chondrocyte viability or tissue water content after 2 hours of arthroscopic irrigation. On the basis of potential benefits in conjunction with the safety demonstrated in these data, clinical evaluation of a hyperosmolar solution for irrigation during shoulder arthroscopy appears warranted.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2014.12.027</identifier><identifier>PMID: 25725966</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Animals ; Arthroscopy ; Arthroscopy - methods ; canine ; Cartilage, Articular - drug effects ; Cartilage, Articular - pathology ; chondrocyte viability ; Disease Models, Animal ; Dogs ; extravasation ; hyperosmolar ; Intraoperative Care - methods ; irrigation solution ; Joint Diseases - drug therapy ; Joint Diseases - pathology ; Joint Diseases - surgery ; Orthopedics ; Saline Solution, Hypertonic - administration & dosage ; Shoulder Joint - drug effects ; Shoulder Joint - pathology ; Shoulder Joint - surgery ; Therapeutic Irrigation - methods</subject><ispartof>Journal of shoulder and elbow surgery, 2015-08, Vol.24 (8), p.1243-1248</ispartof><rights>Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2015 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-8c43a717a8e42b9b79c7558e9d4272bdb970b2c74e1cdb2ecfb5ed20ab4769fd3</citedby><cites>FETCH-LOGICAL-c478t-8c43a717a8e42b9b79c7558e9d4272bdb970b2c74e1cdb2ecfb5ed20ab4769fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1058274615000130$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25725966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Capito, Nicholas M., MD</creatorcontrib><creatorcontrib>Smith, Matthew J., MD</creatorcontrib><creatorcontrib>Stoker, Aaron M., PhD</creatorcontrib><creatorcontrib>Werner, Nikki</creatorcontrib><creatorcontrib>Cook, James L., DVM, PhD</creatorcontrib><title>Hyperosmolar irrigation compared with a standard solution in a canine shoulder arthroscopy model</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>Background A hyperosmolar irrigation solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar irrigation solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study. Methods We designed a translational animal model study in which hyperosmolar arthroscopy irrigation fluid (1.8%, 600 mOsm/L) was compared with normal saline (0.9%, 300 mOsm/L). Purpose-bred research dogs (n = 5) underwent bilateral shoulder arthroscopy. Irrigation fluid was delivered to each shoulder joint (n = 10) at 40 mm Hg for 120 minutes using standard ingress and egress portals. The percentage change in shoulder girth was documented at the completion of 120 minutes. Articular cartilage sections from the glenoid and humeral head were harvested from both shoulders. Chondrocyte viability and tissue water content were evaluated. Differences between groups and compared with time 0 controls were determined, with significance set at P <.05. Results The mean percentage change in shoulder girth was higher in the isotonic control group (13.3%) than in the hyperosmolar group (10.4%). Chondrocyte viability and tissue water content for glenoid and humeral head cartilage were well maintained in both treatment groups, and differences were not statistically significant. Conclusions The data from this study suggest that doubling the osmolarity of the standard irrigation solution used for arthroscopy was not associated with any detrimental effects on chondrocyte viability or tissue water content after 2 hours of arthroscopic irrigation. On the basis of potential benefits in conjunction with the safety demonstrated in these data, clinical evaluation of a hyperosmolar solution for irrigation during shoulder arthroscopy appears warranted.</description><subject>Animals</subject><subject>Arthroscopy</subject><subject>Arthroscopy - methods</subject><subject>canine</subject><subject>Cartilage, Articular - drug effects</subject><subject>Cartilage, Articular - pathology</subject><subject>chondrocyte viability</subject><subject>Disease Models, Animal</subject><subject>Dogs</subject><subject>extravasation</subject><subject>hyperosmolar</subject><subject>Intraoperative Care - methods</subject><subject>irrigation solution</subject><subject>Joint Diseases - drug therapy</subject><subject>Joint Diseases - pathology</subject><subject>Joint Diseases - surgery</subject><subject>Orthopedics</subject><subject>Saline Solution, Hypertonic - administration & dosage</subject><subject>Shoulder Joint - drug effects</subject><subject>Shoulder Joint - pathology</subject><subject>Shoulder Joint - surgery</subject><subject>Therapeutic Irrigation - methods</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU-P1SAUxYnROOPoB3BjWLppBQqljYmJmahjMokLxzXy5z4flUKFdsz79sPzjS5m4YJccnPOCfwOQi8paSmh_ZupnQq0jFDeUtYSJh-hcyo61vSCkMf1TsTQMMn7M_SslIkQMnLCnqIzJiQTY9-fo-9XhwVyKnMKOmOfs_-hV58itmledAaHf_t1jzUuq45OZ4dLCtsfhY91bXX0EXDZpy04yFjndV_jbFoOeE4OwnP0ZKdDgRf38wJ9-_jh5vKquf7y6fPl--vGcjmszWB5pyWVegDOzGjkaKUQA4yOM8mMM6MkhlnJgVpnGNidEeAY0YbLfty57gK9PuUuOf3aoKxq9sVCCDpC2oqi_SilqIdVKT1JbX1pybBTS_azzgdFiTqCVZOqYNURrKJMVbDV8-o-fjMzuH-OvySr4O1JAPWTtx6yKtZDtOB8Brsql_x_4989cNvgo7c6_IQDlCltOVZ6iqpSDerrsdljsbQWTWhHujutlZ_e</recordid><startdate>20150801</startdate><enddate>20150801</enddate><creator>Capito, Nicholas M., MD</creator><creator>Smith, Matthew J., MD</creator><creator>Stoker, Aaron M., PhD</creator><creator>Werner, Nikki</creator><creator>Cook, James L., DVM, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150801</creationdate><title>Hyperosmolar irrigation compared with a standard solution in a canine shoulder arthroscopy model</title><author>Capito, Nicholas M., MD ; Smith, Matthew J., MD ; Stoker, Aaron M., PhD ; Werner, Nikki ; Cook, James L., DVM, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-8c43a717a8e42b9b79c7558e9d4272bdb970b2c74e1cdb2ecfb5ed20ab4769fd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Animals</topic><topic>Arthroscopy</topic><topic>Arthroscopy - methods</topic><topic>canine</topic><topic>Cartilage, Articular - drug effects</topic><topic>Cartilage, Articular - pathology</topic><topic>chondrocyte viability</topic><topic>Disease Models, Animal</topic><topic>Dogs</topic><topic>extravasation</topic><topic>hyperosmolar</topic><topic>Intraoperative Care - methods</topic><topic>irrigation solution</topic><topic>Joint Diseases - drug therapy</topic><topic>Joint Diseases - pathology</topic><topic>Joint Diseases - surgery</topic><topic>Orthopedics</topic><topic>Saline Solution, Hypertonic - administration & dosage</topic><topic>Shoulder Joint - drug effects</topic><topic>Shoulder Joint - pathology</topic><topic>Shoulder Joint - surgery</topic><topic>Therapeutic Irrigation - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Capito, Nicholas M., MD</creatorcontrib><creatorcontrib>Smith, Matthew J., MD</creatorcontrib><creatorcontrib>Stoker, Aaron M., PhD</creatorcontrib><creatorcontrib>Werner, Nikki</creatorcontrib><creatorcontrib>Cook, James L., DVM, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Capito, Nicholas M., MD</au><au>Smith, Matthew J., MD</au><au>Stoker, Aaron M., PhD</au><au>Werner, Nikki</au><au>Cook, James L., DVM, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperosmolar irrigation compared with a standard solution in a canine shoulder arthroscopy model</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2015-08-01</date><risdate>2015</risdate><volume>24</volume><issue>8</issue><spage>1243</spage><epage>1248</epage><pages>1243-1248</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><abstract>Background A hyperosmolar irrigation solution may decrease fluid extravasation during arthroscopic procedures. Demonstrating the safety of a hyperosmolar irrigation solution with respect to chondrocyte viability and cartilage water content was deemed necessary before designing a clinical efficacy study. Methods We designed a translational animal model study in which hyperosmolar arthroscopy irrigation fluid (1.8%, 600 mOsm/L) was compared with normal saline (0.9%, 300 mOsm/L). Purpose-bred research dogs (n = 5) underwent bilateral shoulder arthroscopy. Irrigation fluid was delivered to each shoulder joint (n = 10) at 40 mm Hg for 120 minutes using standard ingress and egress portals. The percentage change in shoulder girth was documented at the completion of 120 minutes. Articular cartilage sections from the glenoid and humeral head were harvested from both shoulders. Chondrocyte viability and tissue water content were evaluated. Differences between groups and compared with time 0 controls were determined, with significance set at P <.05. Results The mean percentage change in shoulder girth was higher in the isotonic control group (13.3%) than in the hyperosmolar group (10.4%). Chondrocyte viability and tissue water content for glenoid and humeral head cartilage were well maintained in both treatment groups, and differences were not statistically significant. Conclusions The data from this study suggest that doubling the osmolarity of the standard irrigation solution used for arthroscopy was not associated with any detrimental effects on chondrocyte viability or tissue water content after 2 hours of arthroscopic irrigation. On the basis of potential benefits in conjunction with the safety demonstrated in these data, clinical evaluation of a hyperosmolar solution for irrigation during shoulder arthroscopy appears warranted.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25725966</pmid><doi>10.1016/j.jse.2014.12.027</doi><tpages>6</tpages></addata></record> |
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| subjects | Animals Arthroscopy Arthroscopy - methods canine Cartilage, Articular - drug effects Cartilage, Articular - pathology chondrocyte viability Disease Models, Animal Dogs extravasation hyperosmolar Intraoperative Care - methods irrigation solution Joint Diseases - drug therapy Joint Diseases - pathology Joint Diseases - surgery Orthopedics Saline Solution, Hypertonic - administration & dosage Shoulder Joint - drug effects Shoulder Joint - pathology Shoulder Joint - surgery Therapeutic Irrigation - methods |
| title | Hyperosmolar irrigation compared with a standard solution in a canine shoulder arthroscopy model |
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