Long-Term Effects of Bupivacaine on Cartilage in a Rabbit Shoulder Model
Background Previous investigations have reported on the chondrotoxicity of bupivacaine in short-term in vivo and in vitro models. This study was designed to provide additional information on the long-term effects of bupivacaine infusion on articular cartilage in an established rabbit shoulder model....
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creator | Gomoll, Andreas H. Yanke, Adam B. Kang, Richard W. Chubinskaya, Susan Williams, James M. Bach, Bernard R. Cole, Brian J. |
description | Background Previous investigations have reported on the chondrotoxicity of bupivacaine in short-term in vivo and in vitro models. This
study was designed to provide additional information on the long-term effects of bupivacaine infusion on articular cartilage
in an established rabbit shoulder model.
Hypothesis Infusion of bupivacaine into the rabbit shoulder will have long-term deleterious effects on articular cartilage.
Study Design Controlled laboratory study.
Methods Thirty-six rabbits were randomized into 3 groups and were infused over 48 hours with saline (S), bupivacaine alone (B), or
bupivacaine with epinephrine (B+E) into the glenohumeral joint. Animals were sacrificed after 3 months, and tissue samples
were analyzed with live/dead cell assay, proteoglycan (PG) synthesis and content assays, and conventional histological evaluation.
Results No macroscopic or radiographic changes were detected in the infused shoulders. Sulfate uptake of infused shoulders relative
to controls was elevated to 112% ±39% (S), 166% ±67% (B), and 210% ±127% (B+E). Statistical analysis of PG content demonstrated
significantly increased levels in bupivacaine groups compared with saline. There were no significant differences among groups
in cell count, percentage of living cells, or histological grade.
Conclusions No permanent impairment of cartilage function was detected 3 months after intra-articular infusion of bupivacaine. Cartilage
metabolism was increased, indicating a possible reparative response. This suggests that, at least in the model used, articular
cartilage has the ability to recover from the chondrotoxic effects of bupivacaine infusion. Before extrapolating these results
to human cartilage, other factors including underlying cartilage injury or disease, decreased chondrocyte density, and increased
bupivacaine dosing need to be taken into account.
Clinical Relevance Bupivacaine toxicity has recently been implicated in the development of chondrolysis after arthroscopic shoulder procedures,
but these findings suggest that additional noxious stimuli might be required before permanent damage ensues. |
doi_str_mv | 10.1177/0363546508323748 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_20660815</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0363546508323748</sage_id><sourcerecordid>1908235685</sourcerecordid><originalsourceid>FETCH-LOGICAL-c479t-4f45a72a86aa99cbfd071bfe1e11abdd1eb5dd6ac5e5867f80753c8549d2fbe03</originalsourceid><addsrcrecordid>eNp10EuLFDEUBeAgitMzunclAR-70jwqj1pqM-MILYKO63Arj-40qUqbVCn-e6vpRmXAVRb3OzeXg9AzSt5QqtRbwiUXrRREc8ZVqx-gFRWCNZxL8RCtjuPmOL9Al7XuCSFUSf0YXVC9BFpNV-h2k8dtc-fLgK9D8HaqOAf8fj7EH2Ahjh7nEa-hTDHB1uM4YsBfoO_jhL_u8pycL_hTdj49QY8CpOqfnt8r9O3m-m5922w-f_i4frdpbKu6qWlDK0Ax0BKg62wfHFG0D556SqF3jvpeOCfBCi-0VEETJbjVou0cC70n_Aq9Pu09lPx99nUyQ6zWpwSjz3M1jEhJNBULfHEP7vNcxuU2QzuiGRdSHxU5KVtyrcUHcyhxgPLLUGKOHZv7HS-R5-fFcz949zdwLnUBr84AqoUUCow21j-OUcJaRvjimpOrS7X_XPf_j1-e_C5udz9j8aYOkNJyBjewr1wZahTjvwFeBZt4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1908235685</pqid></control><display><type>article</type><title>Long-Term Effects of Bupivacaine on Cartilage in a Rabbit Shoulder Model</title><source>MEDLINE</source><source>SAGE Complete A-Z List</source><source>Alma/SFX Local Collection</source><creator>Gomoll, Andreas H. ; Yanke, Adam B. ; Kang, Richard W. ; Chubinskaya, Susan ; Williams, James M. ; Bach, Bernard R. ; Cole, Brian J.</creator><creatorcontrib>Gomoll, Andreas H. ; Yanke, Adam B. ; Kang, Richard W. ; Chubinskaya, Susan ; Williams, James M. ; Bach, Bernard R. ; Cole, Brian J.</creatorcontrib><description>Background Previous investigations have reported on the chondrotoxicity of bupivacaine in short-term in vivo and in vitro models. This
study was designed to provide additional information on the long-term effects of bupivacaine infusion on articular cartilage
in an established rabbit shoulder model.
Hypothesis Infusion of bupivacaine into the rabbit shoulder will have long-term deleterious effects on articular cartilage.
Study Design Controlled laboratory study.
Methods Thirty-six rabbits were randomized into 3 groups and were infused over 48 hours with saline (S), bupivacaine alone (B), or
bupivacaine with epinephrine (B+E) into the glenohumeral joint. Animals were sacrificed after 3 months, and tissue samples
were analyzed with live/dead cell assay, proteoglycan (PG) synthesis and content assays, and conventional histological evaluation.
Results No macroscopic or radiographic changes were detected in the infused shoulders. Sulfate uptake of infused shoulders relative
to controls was elevated to 112% ±39% (S), 166% ±67% (B), and 210% ±127% (B+E). Statistical analysis of PG content demonstrated
significantly increased levels in bupivacaine groups compared with saline. There were no significant differences among groups
in cell count, percentage of living cells, or histological grade.
Conclusions No permanent impairment of cartilage function was detected 3 months after intra-articular infusion of bupivacaine. Cartilage
metabolism was increased, indicating a possible reparative response. This suggests that, at least in the model used, articular
cartilage has the ability to recover from the chondrotoxic effects of bupivacaine infusion. Before extrapolating these results
to human cartilage, other factors including underlying cartilage injury or disease, decreased chondrocyte density, and increased
bupivacaine dosing need to be taken into account.
Clinical Relevance Bupivacaine toxicity has recently been implicated in the development of chondrolysis after arthroscopic shoulder procedures,
but these findings suggest that additional noxious stimuli might be required before permanent damage ensues.</description><identifier>ISSN: 0363-5465</identifier><identifier>EISSN: 1552-3365</identifier><identifier>DOI: 10.1177/0363546508323748</identifier><identifier>PMID: 18832481</identifier><identifier>CODEN: AJSMDO</identifier><language>eng</language><publisher>Los Angeles, CA: American Orthopaedic Society for Sports Medicine</publisher><subject>Anesthetics, Local - administration & dosage ; Anesthetics, Local - pharmacology ; Animals ; Arthroscopy ; Biological and medical sciences ; Bupivacaine - administration & dosage ; Bupivacaine - pharmacology ; Cartilage ; Cartilage, Articular - drug effects ; Diseases of the osteoarticular system ; Endoscopy ; Investigative techniques, diagnostic techniques (general aspects) ; Medical sciences ; Outcome Assessment (Health Care) ; Pain - drug therapy ; Rabbits ; Random Allocation ; Shoulder ; Shoulder Joint - drug effects ; Sports medicine ; Toxicity</subject><ispartof>The American journal of sports medicine, 2009-01, Vol.37 (1), p.72-77</ispartof><rights>2009 American Orthopaedic Society for Sports Medicine</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Sage Publications Ltd. Jan 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c479t-4f45a72a86aa99cbfd071bfe1e11abdd1eb5dd6ac5e5867f80753c8549d2fbe03</citedby><cites>FETCH-LOGICAL-c479t-4f45a72a86aa99cbfd071bfe1e11abdd1eb5dd6ac5e5867f80753c8549d2fbe03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0363546508323748$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0363546508323748$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,4010,21800,27904,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21024203$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18832481$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gomoll, Andreas H.</creatorcontrib><creatorcontrib>Yanke, Adam B.</creatorcontrib><creatorcontrib>Kang, Richard W.</creatorcontrib><creatorcontrib>Chubinskaya, Susan</creatorcontrib><creatorcontrib>Williams, James M.</creatorcontrib><creatorcontrib>Bach, Bernard R.</creatorcontrib><creatorcontrib>Cole, Brian J.</creatorcontrib><title>Long-Term Effects of Bupivacaine on Cartilage in a Rabbit Shoulder Model</title><title>The American journal of sports medicine</title><addtitle>Am J Sports Med</addtitle><description>Background Previous investigations have reported on the chondrotoxicity of bupivacaine in short-term in vivo and in vitro models. This
study was designed to provide additional information on the long-term effects of bupivacaine infusion on articular cartilage
in an established rabbit shoulder model.
Hypothesis Infusion of bupivacaine into the rabbit shoulder will have long-term deleterious effects on articular cartilage.
Study Design Controlled laboratory study.
Methods Thirty-six rabbits were randomized into 3 groups and were infused over 48 hours with saline (S), bupivacaine alone (B), or
bupivacaine with epinephrine (B+E) into the glenohumeral joint. Animals were sacrificed after 3 months, and tissue samples
were analyzed with live/dead cell assay, proteoglycan (PG) synthesis and content assays, and conventional histological evaluation.
Results No macroscopic or radiographic changes were detected in the infused shoulders. Sulfate uptake of infused shoulders relative
to controls was elevated to 112% ±39% (S), 166% ±67% (B), and 210% ±127% (B+E). Statistical analysis of PG content demonstrated
significantly increased levels in bupivacaine groups compared with saline. There were no significant differences among groups
in cell count, percentage of living cells, or histological grade.
Conclusions No permanent impairment of cartilage function was detected 3 months after intra-articular infusion of bupivacaine. Cartilage
metabolism was increased, indicating a possible reparative response. This suggests that, at least in the model used, articular
cartilage has the ability to recover from the chondrotoxic effects of bupivacaine infusion. Before extrapolating these results
to human cartilage, other factors including underlying cartilage injury or disease, decreased chondrocyte density, and increased
bupivacaine dosing need to be taken into account.
Clinical Relevance Bupivacaine toxicity has recently been implicated in the development of chondrolysis after arthroscopic shoulder procedures,
but these findings suggest that additional noxious stimuli might be required before permanent damage ensues.</description><subject>Anesthetics, Local - administration & dosage</subject><subject>Anesthetics, Local - pharmacology</subject><subject>Animals</subject><subject>Arthroscopy</subject><subject>Biological and medical sciences</subject><subject>Bupivacaine - administration & dosage</subject><subject>Bupivacaine - pharmacology</subject><subject>Cartilage</subject><subject>Cartilage, Articular - drug effects</subject><subject>Diseases of the osteoarticular system</subject><subject>Endoscopy</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Medical sciences</subject><subject>Outcome Assessment (Health Care)</subject><subject>Pain - drug therapy</subject><subject>Rabbits</subject><subject>Random Allocation</subject><subject>Shoulder</subject><subject>Shoulder Joint - drug effects</subject><subject>Sports medicine</subject><subject>Toxicity</subject><issn>0363-5465</issn><issn>1552-3365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10EuLFDEUBeAgitMzunclAR-70jwqj1pqM-MILYKO63Arj-40qUqbVCn-e6vpRmXAVRb3OzeXg9AzSt5QqtRbwiUXrRREc8ZVqx-gFRWCNZxL8RCtjuPmOL9Al7XuCSFUSf0YXVC9BFpNV-h2k8dtc-fLgK9D8HaqOAf8fj7EH2Ahjh7nEa-hTDHB1uM4YsBfoO_jhL_u8pycL_hTdj49QY8CpOqfnt8r9O3m-m5922w-f_i4frdpbKu6qWlDK0Ax0BKg62wfHFG0D556SqF3jvpeOCfBCi-0VEETJbjVou0cC70n_Aq9Pu09lPx99nUyQ6zWpwSjz3M1jEhJNBULfHEP7vNcxuU2QzuiGRdSHxU5KVtyrcUHcyhxgPLLUGKOHZv7HS-R5-fFcz949zdwLnUBr84AqoUUCow21j-OUcJaRvjimpOrS7X_XPf_j1-e_C5udz9j8aYOkNJyBjewr1wZahTjvwFeBZt4</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Gomoll, Andreas H.</creator><creator>Yanke, Adam B.</creator><creator>Kang, Richard W.</creator><creator>Chubinskaya, Susan</creator><creator>Williams, James M.</creator><creator>Bach, Bernard R.</creator><creator>Cole, Brian J.</creator><general>American Orthopaedic Society for Sports Medicine</general><general>SAGE Publications</general><general>Sage Publications</general><general>Sage Publications Ltd</general><scope>IQODW</scope><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>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7QP</scope></search><sort><creationdate>20090101</creationdate><title>Long-Term Effects of Bupivacaine on Cartilage in a Rabbit Shoulder Model</title><author>Gomoll, Andreas H. ; Yanke, Adam B. ; Kang, Richard W. ; Chubinskaya, Susan ; Williams, James M. ; Bach, Bernard R. ; Cole, Brian J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c479t-4f45a72a86aa99cbfd071bfe1e11abdd1eb5dd6ac5e5867f80753c8549d2fbe03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Anesthetics, Local - administration & dosage</topic><topic>Anesthetics, Local - pharmacology</topic><topic>Animals</topic><topic>Arthroscopy</topic><topic>Biological and medical sciences</topic><topic>Bupivacaine - administration & dosage</topic><topic>Bupivacaine - pharmacology</topic><topic>Cartilage</topic><topic>Cartilage, Articular - drug effects</topic><topic>Diseases of the osteoarticular system</topic><topic>Endoscopy</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Medical sciences</topic><topic>Outcome Assessment (Health Care)</topic><topic>Pain - drug therapy</topic><topic>Rabbits</topic><topic>Random Allocation</topic><topic>Shoulder</topic><topic>Shoulder Joint - drug effects</topic><topic>Sports medicine</topic><topic>Toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gomoll, Andreas H.</creatorcontrib><creatorcontrib>Yanke, Adam B.</creatorcontrib><creatorcontrib>Kang, Richard W.</creatorcontrib><creatorcontrib>Chubinskaya, Susan</creatorcontrib><creatorcontrib>Williams, James M.</creatorcontrib><creatorcontrib>Bach, Bernard R.</creatorcontrib><creatorcontrib>Cole, Brian J.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Calcium & Calcified Tissue Abstracts</collection><jtitle>The American journal of sports medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gomoll, Andreas H.</au><au>Yanke, Adam B.</au><au>Kang, Richard W.</au><au>Chubinskaya, Susan</au><au>Williams, James M.</au><au>Bach, Bernard R.</au><au>Cole, Brian J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Effects of Bupivacaine on Cartilage in a Rabbit Shoulder Model</atitle><jtitle>The American journal of sports medicine</jtitle><addtitle>Am J Sports Med</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>37</volume><issue>1</issue><spage>72</spage><epage>77</epage><pages>72-77</pages><issn>0363-5465</issn><eissn>1552-3365</eissn><coden>AJSMDO</coden><abstract>Background Previous investigations have reported on the chondrotoxicity of bupivacaine in short-term in vivo and in vitro models. This
study was designed to provide additional information on the long-term effects of bupivacaine infusion on articular cartilage
in an established rabbit shoulder model.
Hypothesis Infusion of bupivacaine into the rabbit shoulder will have long-term deleterious effects on articular cartilage.
Study Design Controlled laboratory study.
Methods Thirty-six rabbits were randomized into 3 groups and were infused over 48 hours with saline (S), bupivacaine alone (B), or
bupivacaine with epinephrine (B+E) into the glenohumeral joint. Animals were sacrificed after 3 months, and tissue samples
were analyzed with live/dead cell assay, proteoglycan (PG) synthesis and content assays, and conventional histological evaluation.
Results No macroscopic or radiographic changes were detected in the infused shoulders. Sulfate uptake of infused shoulders relative
to controls was elevated to 112% ±39% (S), 166% ±67% (B), and 210% ±127% (B+E). Statistical analysis of PG content demonstrated
significantly increased levels in bupivacaine groups compared with saline. There were no significant differences among groups
in cell count, percentage of living cells, or histological grade.
Conclusions No permanent impairment of cartilage function was detected 3 months after intra-articular infusion of bupivacaine. Cartilage
metabolism was increased, indicating a possible reparative response. This suggests that, at least in the model used, articular
cartilage has the ability to recover from the chondrotoxic effects of bupivacaine infusion. Before extrapolating these results
to human cartilage, other factors including underlying cartilage injury or disease, decreased chondrocyte density, and increased
bupivacaine dosing need to be taken into account.
Clinical Relevance Bupivacaine toxicity has recently been implicated in the development of chondrolysis after arthroscopic shoulder procedures,
but these findings suggest that additional noxious stimuli might be required before permanent damage ensues.</abstract><cop>Los Angeles, CA</cop><pub>American Orthopaedic Society for Sports Medicine</pub><pmid>18832481</pmid><doi>10.1177/0363546508323748</doi><tpages>6</tpages></addata></record> |
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source | MEDLINE; SAGE Complete A-Z List; Alma/SFX Local Collection |
subjects | Anesthetics, Local - administration & dosage Anesthetics, Local - pharmacology Animals Arthroscopy Biological and medical sciences Bupivacaine - administration & dosage Bupivacaine - pharmacology Cartilage Cartilage, Articular - drug effects Diseases of the osteoarticular system Endoscopy Investigative techniques, diagnostic techniques (general aspects) Medical sciences Outcome Assessment (Health Care) Pain - drug therapy Rabbits Random Allocation Shoulder Shoulder Joint - drug effects Sports medicine Toxicity |
title | Long-Term Effects of Bupivacaine on Cartilage in a Rabbit Shoulder Model |
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