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An Examination of the in Vitro Effects on Fibroblasts of Periarticular Injection Solution Applied in Total Hip and Knee Arthroplasty

Received: 16 June 2021     Accepted: 29 June 2021     Published: 8 July 2021
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Abstract

The number of indications for total hip and knee surgery is increasing. The anesthesia and analgesia techniques are very important and effectivity on success of total hip and knee arthroplasty. Multimodal analgesia makes a great contribution to pain treatment after surgery. Periarticular injection of an analgesic solution is a component of multimodal analgesia. However, it has long been unclear whether such injections damage tissue. The fibroblasts were cultured in 5 mL of D-MEM/F-12 medium in each well of a 6-well culture dish. After 1 hour, we added 5 mL of prepared periarticular injection solution to each well of the study group. To determine the effects of the solution on the fibroblasts, we assessed viability rates at the end of 24, 48, and 72 hours. When we compared the control and the study group, we did not encounter any apoptotic or dying cells in either group, which we interpreted to mean that the periarticular injection solution did not show a lethal effect on fibroblasts. Therefore, we conducted an in vitro and electron microscope study to research this issue. We found that the number and viability of fibroblasts did not change significantly with periarticular injection and thus concluded does not cause cell damage and can safely be used.

Published in International Journal of Anesthesia and Clinical Medicine (Volume 9, Issue 2)
DOI 10.11648/j.ijacm.20210902.12
Page(s) 28-31
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Periarticular Injection, Hip and Knee Arthroplasty, Analgesia, Fibroblast

References
[1] Elmallah RK, Chuqtai M, Khlopas A, Newman JM, Stearns KL, Roche M, Kelly MA, Harwin SF, Mont MA. Pain Control in Total Knee Arthroplasty. Knee Surg 2018; 31 (6): 504-513.
[2] Ross JA, Greenwood AC, Sasser P, Jiranek WA. Periarticular Injections in Knee and Hip Arthroplasty: Where and What to Inject. J Arthroplasty 2017; 32 (9S): S77-S80.
[3] Parvataneni HK, Shah VP, Howard H, Cole N, Ranawat AS, Ranawat CS. Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: a prospective randomized study. J Arthoplasty 2007; 22 (,6 Suppl 2): 33-8.
[4] Maheswari AV, Blum YC, Shekhar L, Ranawat AS, Ranawat CS. Multimodal pain management after total hip and knee arthroplasty at the Ranawat Orthopaedic Center. Clin Orthop Relat Res 2009; 467 (6): 1418.
[5] Parvataneni HK, Ranawat AS, Ranawat CS. The use of local periarticular injections in the management of postoperative pain after total hip and knee replacement: a multimodal approach. Instr Course Lect 2007; 56: 125.
[6] Li R, Ma H, Zhang X, Li C, Xiong J, Lu T, Mao Y, Dai J, Liu L, Ding Z. Impaired autophagosome clearance contributes to local anesthetic bupivacaine-induced myotoxicity in mouse myoblasts. Anesthesiology. 2015 Mar; 122 (3): 595-605. doi: 10.1097/ALN.0000000000000568.
[7] Mullaji A, Kanna R, Shetty GM, Chavda V, Singh DP. Efficacy of periarticular injection of bupivacaine, fentanyl, and methylprednisolone in total knee arthroplasty: a prospective, randomized trial. J Arthroplasty 2010; 25: 851-7.
[8] Andersen KV, Nikolajsen L, Haraldsted V, Odgaard A, Soballe K. Local infiltration analgesia for total knee arthroplasty: should ketorolac be added? Br J Anaesth 2013; 111: 242-8.
[9] Lamplot JD, Wagner ER, Manning DW. Multimodal pain management in total knee arthroplasty: a prospective randomized controlled trial. J Arthroplasty 2014; 29: 329.
[10] Leone S, Di Cianni S, Casati A, Fanelli G. Pharmacology, toxicology, and clinical use of new long acting local anesthetics, ropivacaine and levobupivacaine. Acta Biomed 2008; 79: 92-105.
[11] Ng FY, Ng JK, Chiu KY, Yan CH, Chan CW. Multimodal periarticular injection vs continuous femoral nerve block after total knee arthroplasty: a prospective, crossover, randomized clinical trial. J Arthroplasty 2012; 27: 1234-8.
[12] Wu JW, Wong YC. Elective unilateral total knee replacement using continuous femoral nerve blockade versus conventional patient-controlled analgesia: perioperative patient management based on a multidisciplinary pathway. Hong Kong Med J 2014; 20: 45-51.
[13] Ma HH, Chou TFA, Tsai SW, Chen CF, The efficacy of intraopertaive periarticular injection in total hip arthroplasty: a systemic review and meta-analysis BMC Musculoskeletal Disorders. 2019; 29: 269-78.
[14] Ban WR, Zhang EA, Lv LF, Dang XQ, Zhang C. Effects of periarticular injection on analgesic effects and NSAID use in total knee arthroplasty and total hip arthroplasty. Clinics. 2017; 72 (12): 729–36.
[15] Villatte G, Engels E, Erivan R, Mulliez A, Caumon N, Boisgard S, Descamps S. Effect of local anaesthetic wound infiltration on acute pain and bleeding after primary total hip arthroplasty: the EDIPO randomised controlled study. Int Orthop. 2016; 40 (11): 2255–60.
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    Muhammed Sadik Bilgen, Zeynep Kahveci, Ilkin Cavusoglu, Muren Mutlu, Omer Faruk Bilgen, et al. (2021). An Examination of the in Vitro Effects on Fibroblasts of Periarticular Injection Solution Applied in Total Hip and Knee Arthroplasty. International Journal of Anesthesia and Clinical Medicine, 9(2), 28-31. https://doi.org/10.11648/j.ijacm.20210902.12

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    ACS Style

    Muhammed Sadik Bilgen; Zeynep Kahveci; Ilkin Cavusoglu; Muren Mutlu; Omer Faruk Bilgen, et al. An Examination of the in Vitro Effects on Fibroblasts of Periarticular Injection Solution Applied in Total Hip and Knee Arthroplasty. Int. J. Anesth. Clin. Med. 2021, 9(2), 28-31. doi: 10.11648/j.ijacm.20210902.12

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    AMA Style

    Muhammed Sadik Bilgen, Zeynep Kahveci, Ilkin Cavusoglu, Muren Mutlu, Omer Faruk Bilgen, et al. An Examination of the in Vitro Effects on Fibroblasts of Periarticular Injection Solution Applied in Total Hip and Knee Arthroplasty. Int J Anesth Clin Med. 2021;9(2):28-31. doi: 10.11648/j.ijacm.20210902.12

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  • @article{10.11648/j.ijacm.20210902.12,
      author = {Muhammed Sadik Bilgen and Zeynep Kahveci and Ilkin Cavusoglu and Muren Mutlu and Omer Faruk Bilgen and Aysun Yilmazlar},
      title = {An Examination of the in Vitro Effects on Fibroblasts of Periarticular Injection Solution Applied in Total Hip and Knee Arthroplasty},
      journal = {International Journal of Anesthesia and Clinical Medicine},
      volume = {9},
      number = {2},
      pages = {28-31},
      doi = {10.11648/j.ijacm.20210902.12},
      url = {https://doi.org/10.11648/j.ijacm.20210902.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20210902.12},
      abstract = {The number of indications for total hip and knee surgery is increasing. The anesthesia and analgesia techniques are very important and effectivity on success of total hip and knee arthroplasty. Multimodal analgesia makes a great contribution to pain treatment after surgery. Periarticular injection of an analgesic solution is a component of multimodal analgesia. However, it has long been unclear whether such injections damage tissue. The fibroblasts were cultured in 5 mL of D-MEM/F-12 medium in each well of a 6-well culture dish. After 1 hour, we added 5 mL of prepared periarticular injection solution to each well of the study group. To determine the effects of the solution on the fibroblasts, we assessed viability rates at the end of 24, 48, and 72 hours. When we compared the control and the study group, we did not encounter any apoptotic or dying cells in either group, which we interpreted to mean that the periarticular injection solution did not show a lethal effect on fibroblasts. Therefore, we conducted an in vitro and electron microscope study to research this issue. We found that the number and viability of fibroblasts did not change significantly with periarticular injection and thus concluded does not cause cell damage and can safely be used.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - An Examination of the in Vitro Effects on Fibroblasts of Periarticular Injection Solution Applied in Total Hip and Knee Arthroplasty
    AU  - Muhammed Sadik Bilgen
    AU  - Zeynep Kahveci
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    DO  - 10.11648/j.ijacm.20210902.12
    T2  - International Journal of Anesthesia and Clinical Medicine
    JF  - International Journal of Anesthesia and Clinical Medicine
    JO  - International Journal of Anesthesia and Clinical Medicine
    SP  - 28
    EP  - 31
    PB  - Science Publishing Group
    SN  - 2997-2698
    UR  - https://doi.org/10.11648/j.ijacm.20210902.12
    AB  - The number of indications for total hip and knee surgery is increasing. The anesthesia and analgesia techniques are very important and effectivity on success of total hip and knee arthroplasty. Multimodal analgesia makes a great contribution to pain treatment after surgery. Periarticular injection of an analgesic solution is a component of multimodal analgesia. However, it has long been unclear whether such injections damage tissue. The fibroblasts were cultured in 5 mL of D-MEM/F-12 medium in each well of a 6-well culture dish. After 1 hour, we added 5 mL of prepared periarticular injection solution to each well of the study group. To determine the effects of the solution on the fibroblasts, we assessed viability rates at the end of 24, 48, and 72 hours. When we compared the control and the study group, we did not encounter any apoptotic or dying cells in either group, which we interpreted to mean that the periarticular injection solution did not show a lethal effect on fibroblasts. Therefore, we conducted an in vitro and electron microscope study to research this issue. We found that the number and viability of fibroblasts did not change significantly with periarticular injection and thus concluded does not cause cell damage and can safely be used.
    VL  - 9
    IS  - 2
    ER  - 

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Author Information
  • Uludag University, Faculty of Medicine, Orthopaedics and Traumatology Department, Bursa, Turkey

  • Uludag University, Faculty of Medicine, Histology and Embryology Department, Bursa, Turkey

  • Uludag University, Faculty of Medicine, Histology and Embryology Department, Bursa, Turkey

  • Private Medicabil Hospital, Orthopaedics and Traumatology Department, Bursa, Turkey

  • Private Medicabil Hospital, Orthopaedics and Traumatology Department, Bursa, Turkey

  • Private Medicabil Hospital, Anaesthesiology and Intensive Care Department, Bursa, Turkey

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