Acetaminophen, bupivacaine, Duramorph, and Toradol: A comparison of chondrocyte viability and gene expression changes in osteoarthritic human chondrocytes

Cooke, Christopher L.; Osborne, Jeffrey; Jackson, Nancy; Keating, Peter; Flynn, Jeffrey C.; Markel, David C.; Chen, Chaoyang; Lemos, Stephen

doi:10.1016/j.knee.2020.10.019

Cited by 5 publications

(4 citation statements)

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“…[20][21][22] Primary cultures of human cartilage cells were used as a cellular model to evaluate and compare the cytotoxic effects of Duramorph (preservative-free morphine; Hikma Pharmaceuticals), ketorolac, bupivacaine, and acetaminophen. Cooke et al 23 explored the chondrotoxic potential of 4 intra-articular injections that are used in clinical and surgical practice. Their data demonstrated that Duramorph is less toxic to chondrocytes compared with the commonly used bupivacaine.…”

Section: See Related Article On Page 1980mentioning

confidence: 99%

Editorial Commentary: Periarticular and Intra-Articular Injections May Do the Right Thing for Patients’ Pain but May Be the Wrong Thing for Their Articular Cartilage: Be Careful

Lemos

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: See Related Article On Page 1980mentioning

confidence: 99%

Editorial Commentary: Periarticular and Intra-Articular Injections May Do the Right Thing for Patients’ Pain but May Be the Wrong Thing for Their Articular Cartilage: Be Careful

Lemos

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Fellows are also requested to initiate a project for the incoming fellow for the following year to ensured that all fellows participated in 2 research projects during their fellowship. Research curriculum included clinical studies [19][20][21][22][23] traditional biomechanical studies [24][25][26] and emerging machine learning Artificial Intelligence (AI) techniques in clinical translational research [27][28][29].…”

Section: Research Projectsmentioning

confidence: 99%

Evaluation of Educational Advancement following a Sports Medicine Rotation

Edward¹,

Allison²,

Patrick³

et al. 2021

Int J Sports Exerc Med

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Background:The competency in orthopaedic surgery and sports medicine has been reported as a deficiency. Sports medicine clinical rotations may improve both medical students' and residents' musculoskeletal knowledge, but none have evaluated the knowledge and skills a resident may gain during the rotation in sports medicine.Objective: The purpose of this study is to determine (1) The knowledge gained by residents at varying levels after rotating within our sports medicine program and (2) The performance of residents in a standardized sports medicine test at the start and end of each resident's rotation in sports medicine. Methods: Total of 136 residents and fellows participated in this study following the Model Curriculum and Guidelines for Orthopaedic Surgery Sports Medicine Fellowship Training created by the American Orthopaedic Society for Sports Medicine Accreditation Council of Graduate Medical Education. Multiple modalities training program were administered, including clinical rotation, laboratory research project, covering professional sport team training, and conference presentation. Their performances were assessed and compared by pre-and post-rotation tests with statistical analysis to determine the improvement of their orthopaedic knowledge. Results:The residents at the fifth of Post-Graduate-Year (PGY 5) scored the highest followed by fellows. PGY5 had the lowest percent change between pre-and post-test. PGY 2 and PGY3 residents scored the lowest overall while having the largest percent change before and after the rotation thereby showing the most improvement.Conclusions: Multiple modalities training program improved residents and fellows' performance and knowledge in sports medicine.

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“…4 Evidence suggests that bupivacaine may be more chondrotoxic than other local anesthetics such as ropivacaine and mepivacaine. 1,5 However, some studies have demonstrated no detrimental effect of bupivacaine exposure on long-term chondrocyte viability. For example, a rabbit model study found no effect of bupivacaine or bupivacaine in conjunction with epinephrine on viability 3 months after exposure, suggesting perhaps these chondrotoxic effects observed in the short-term may be transient.…”

Section: Introductionmentioning

confidence: 99%

“…4 Evidence suggests that bupivacaine may be more chondrotoxic than other local anesthetics such as ropivacaine and mepivacaine. 1,5…”

Section: Introductionmentioning

confidence: 99%

The Longer-Term Effects of a Single Bupivacaine Exposure on the Mechanical Properties of Native Cartilage Explants

et al. 2023

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Objective The purpose of this study was to determine the in vitro effects of a single exposure of bupivacaine on the mechanical properties of bovine cartilage explants at 3 weeks. Design Femoral condyle articular cartilage explants were aseptically harvested from juvenile bovine stifle joints before being exposed to chondrogenic medium containing 0.50% (wt/vol) bupivacaine, 0.25% (wt/vol) bupivacaine, or no medication (control) for 1 hour. Explants were then washed and maintained in culture in vitro for 3 weeks before testing. Cell viability, tensile and compressive mechanical properties, histological properties, and biochemical properties were then assessed. Results Explants exhibited a dose-dependent decrease in mean tensile Young’s modulus with increasing bupivacaine concentration (9.86 MPa in the controls, 6.48 MPa in the 0.25% bupivacaine group [ P = 0.048], and 4.72 MPa in the 0.50% bupivacaine group [ P = 0.005]). Consistent with these results, collagen content and collagen crosslinking decreased with bupivacaine exposure as measured by mass spectrometry. Compressive properties of the explants were unaffected by bupivacaine exposure. Explants also exhibited a trend toward dose-dependent decreases in viability (51.2% for the controls, 47.3% for the 0.25% bupivacaine-exposed group, and 37.0% for the 0.50% bupivacaine-exposed group [ P = 0.072]). Conclusions Three weeks after 1-hour bupivacaine exposure, the tensile properties of bovine cartilage explants were significantly decreased, while the compressive properties remained unaffected. These decreases in tensile properties corresponded with reductions in collagen content and crosslinking of collagen fibers. Physicians should be judicious regarding the intra-articular administration of bupivacaine in native joints.

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Acetaminophen, bupivacaine, Duramorph, and Toradol: A comparison of chondrocyte viability and gene expression changes in osteoarthritic human chondrocytes

Cited by 5 publications

References 32 publications

Editorial Commentary: Periarticular and Intra-Articular Injections May Do the Right Thing for Patients’ Pain but May Be the Wrong Thing for Their Articular Cartilage: Be Careful

Editorial Commentary: Periarticular and Intra-Articular Injections May Do the Right Thing for Patients’ Pain but May Be the Wrong Thing for Their Articular Cartilage: Be Careful

Evaluation of Educational Advancement following a Sports Medicine Rotation

The Longer-Term Effects of a Single Bupivacaine Exposure on the Mechanical Properties of Native Cartilage Explants

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