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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

01.07.2011 | Experimental Study

The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study

verfasst von: Tom F. Jacobs, Pieter S. Vansintjan, Nathalie Roels, Sofie S. Herregods, Gust Verbruggen, Luc L. Herregods, Karl F. Almqvist

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 7/2011

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Abstract

Purpose

More and more orthopedic procedures are performed in an outpatient setting. A commonly used strategy in pain management is the intra-articular injection of local anesthetics. Recent attention has been drawn to their possible toxic effect on chondrocytes. Local anesthetics, and in particular Lidocaine, are also used for diagnostic joint infiltrations. A controlled laboratory study was performed to investigate the possible toxic effect of Lidocaine on human articular chondrocytes.

Methods

Mature human articular chondrocytes were harvested from the knees of human tissue donors or patients undergoing total knee replacement. The cells were exposed to Lidocaine 1 and 2% with and without epinephrine and to a saline 0.9% control group, with variable exposure times in different experiments. The activity and viability of the cells were assessed by lactate dehydrogenase activity, interleukin-6 production and a live/dead cell count.

Results

After a 1-h exposure, devastating results were seen for Lidocaine 1, 2 and 2% with epinephrine showing cell death rates of 91, 99 and 97%, respectively, compared with 26% in the saline control group (P-values of 0.004, 0.010, 0.006, respectively).

Exposing the chondrocytes to a 50/50 mixture of culture medium and local anesthetics substantially decreased cytotoxicity but still showed high toxicity when compared with the saline group (90% dead cells for Lidocaine 2%, P = 0.047). Lidocaine also showed a time-dependent cytotoxicity with gradually more dead cells after exposure for 15, 30 or 60 min.

Conclusion

In vitro, local anesthetics containing Lidocaine are significantly more toxic to mature human articular chondrocytes than a saline 0.9% control group. The effect of Lidocaine on the viability of human chondrocytes in vivo needs further investigation. However, based on our in vitro results, cautious use of intra-articular Lidocaine in clinical practice is recommended.

Level of evidence

Prospective, comparative therapeutic study, Level II.

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Titel: The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study
verfasst von: Tom F. Jacobs
Pieter S. Vansintjan
Nathalie Roels
Sofie S. Herregods
Gust Verbruggen
Luc L. Herregods
Karl F. Almqvist
Publikationsdatum: 01.07.2011
Verlag: Springer-Verlag
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 7/2011
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1420-5

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The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study