In Vitro Effects of Triamcinolone and Methylprednisolone on the Viability and Mechanics of Native Articular Cartilage

Fackler, Nathan P.; Yareli-Salinas, Evelia; Callan, Kylie T.; Athanasiou, Kyriacos A.; Wang, Dean

doi:10.1177/03635465231162644

Cited by 4 publications

(1 citation statement)

References 39 publications

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“…Severe in vitro toxicity of betamethasone and methylprednisolone has been reported in canine‐explanted chondrocytes and synoviocytes [ 59 ]. Multiple studies suggested the detrimental effect of CS on human chondrocyte viability in vitro, with both triamcinolone and methylprednisolone showing chondrotoxic effects, and dexamethasone and even more betamethasone presenting a dose‐dependent effect on cellular necrosis [ 19 , 20 , 22 , 23 , 61 ]. Overall, the in vitro studies warn against the possible detrimental effects of CS and underline the importance of investigating molecules and doses with the best risk/benefit ratio to treat OA joints.…”

Section: Discussionmentioning

confidence: 99%

Intra‐articular corticosteroids for the treatment of osteoarthritis: A systematic review and meta‐analysis on the comparison of different molecules and doses

Bensa,

Salerno,

Moraca

et al. 2024

J. exp. orthop.

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PurposeThe purpose of this study was to quantify and compare the clinical relevance of the different intra‐articular corticosteroids (CS) effects in vivo for osteoarthritis (OA) treatment.MethodsThe search was conducted on PubMed, Cochrane, and Web of Science in October 2023. The PRISMA guidelines were used. Inclusion criteria: animal or human randomized controlled trials (RCTs), English language and no time limitation, on the comparison of different intra‐articular CS for OA treatment. The articles' quality was assessed using the Cochrane RoB2 and GRADE guidelines for human RCTs, and SYRCLE's tool for animal RCTs.ResultsEighteen RCTs were selected (16 human and 2 animal studies), including 1577 patients (1837 joints) and 31 animals (51 joints). The CS used were triamcinolone (14 human and 2 animal studies), methylprednisolone (7 human and 1 animal study), betamethasone (3 human studies) and dexamethasone (1 human study). All studies addressed knee OA except for three human and one animal study. A meta‐analysis was performed on the comparison of methylprednisolone and triamcinolone in humans with knee OA analysing VAS pain at very short‐ (≤2 weeks), short‐ (>2 and ≤4 weeks), mid‐ (>4 and ≤8 weeks), long‐ (>8 and ≤ 12 weeks), and very long‐term (>12 and ≤24 weeks). Triamcinolone showed better post‐injection values compared to methylprednisolone at very short‐term (p = 0.028). No difference in terms of VAS improvement was observed at any follow‐up.ConclusionsThe available preclinical and clinical literature provides limited evidence on the comparison of different CS, hindering the possibility of determining the best CS approach in terms of molecule and dose for the intra‐articular injection of OA joints.Level of EvidenceLevel I.

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Section: Discussionmentioning

confidence: 99%

Intra‐articular corticosteroids for the treatment of osteoarthritis: A systematic review and meta‐analysis on the comparison of different molecules and doses

Bensa,

Salerno,

Moraca

et al. 2024

J. exp. orthop.

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Triamcinolone acetonide has minimal effect on short‐ and long‐term metabolic activities of cartilage

Porter,

Newcomb,

DiStefano

et al. 2024

Journal Orthopaedic Research

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Intra‐articular corticosteroid injections, such as triamcinolone acetonide (TA), are commonly used by clinicians to manage joint synovial inflammation. However, due to conflicting evidence in literature, there is a fear among clinicians that the injections may be harmful to otherwise healthy cartilage in young patients. The purpose of this study was to evaluate the effects of TA on young, healthy chondrocytes. Articular cartilage samples were harvested from bovine knee joints (1–2 months old). In both healthy and inflammatory (interleukin‐1β) challenged cartilage, samples were treated with TA at doses ranging from 1 nM to 200 μM. Following a short‐ (2 days) or long‐term (10–14 days) treatment, chondrocyte viability, proliferation, and extracellular matrix (ECM) synthesis and degradation were evaluated with a click chemistry‐based technique. Chondrocyte viability, proliferation, and anabolic activity were all minimally affected by short‐term and long‐term TA treatment. After both acute and sustained inflammatory challenges, TA reduced the catabolic activities in cartilage, reducing nascent glycosaminoglycan loss and maintaining cartilage mechanical properties. Overall, at physiologically relevant doses, TA had minimal negative impact on chondrocytes when maintained within their native ECM. Clinical significance: The findings provide new insight for current clinical practices concerning the use of TA in intra‐articular injections, especially in young patients, and established a foundation for future investigations into the impact of corticosteroids on joint homeostasis.

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The effect of intra-articular steroid injection on the cartilage and tendon thicknesses in juvenile idiopathic arthritis

Şahin,

Özdemir Çiçek,

Paç Kısaarslan

et al. 2023

Modern Rheumatology

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Objectives Intra-articular corticosteroid injection (IACI) is a safe first-line or adjunct therapy used in any subtype of juvenile idiopathic arthritis (JIA). Limited studies evaluated the effect of IACI on cartilage. Our study aimed to examine the femoral cartilage thickness of patients with JIA who received IACI to the knee joint using ultrasound. Methods We randomly selected JIA patients who performed IACI in the knee joint. Baseline bilateral joint cartilage and tendon thicknesses were measured. The articular fluid was aspirated, and applied IACI at the same period. Six months after injection, the exact measurements were repeated. Distal femoral cartilage, quadriceps tendon, and distal and proximal patellar tendon thicknesses were compared at the baseline (before IACI) and 6 months after IACI. Results Thirty patients with JIA were included, and 23 (76.7%) were female. The median age was 11 years (interquartile range, 6 to 14), and the median disease duration was 3.3 years (interquartile range, 5 months to 5 years). The subtypes of JIA were oligoarticular in 25 (83.3%), polyarticular in 2 (6.7%), enthesitis-related arthritis in 2 (6.7%), and juvenile psoriatic arthritis in 1 (3.3%). Distal femoral cartilage thickness was 2.96 ± 0.79 mm at baseline and 2.85 ± 0.70 mm at 6 months after IACI (P = .35). The tendon thicknesses were similar at 6 months after baseline measurements. Conclusions Our findings reveal that knee IACI in patients with JIA did not significantly change cartilage and tendon thicknesses. This observation could indicate that IACIs have no detrimental effects on the cartilage and the tendons.

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In Vitro Effects of Triamcinolone and Methylprednisolone on the Viability and Mechanics of Native Articular Cartilage

Cited by 4 publications

References 39 publications

Intra‐articular corticosteroids for the treatment of osteoarthritis: A systematic review and meta‐analysis on the comparison of different molecules and doses

Intra‐articular corticosteroids for the treatment of osteoarthritis: A systematic review and meta‐analysis on the comparison of different molecules and doses

Triamcinolone acetonide has minimal effect on short‐ and long‐term metabolic activities of cartilage

The effect of intra-articular steroid injection on the cartilage and tendon thicknesses in juvenile idiopathic arthritis

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