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ABSTRACT: The effect of arthroscopic irrigating solutions on articular cartilage was determined by the use of an animal model. Rabbit knee joints were irrigated continuously for two hours with either normal saline, Ringer's lactate, or sterile water. Subsequently, the rate of incorporation of 35SO4 by articular cartilage was used to measure the effect of the irrigants on chondrocyte metabolism. In addition, the irrigated groups were compared to an unirrigated control group. There was no significant difference in 35SO4 incorporation between the groups. This suggested that none of the irrigating solutions used in this study adversely affected articular cartilage function. On the basis of these findings, it appears that normal saline, Ringer's lactate, and sterile water can be safely used as irrigating solutions during most arthroscopic procedures.
Introduction
Arthroscopy is frequently used in both the diagnosis and treatment of many joint disorders. In our institution, nearly 400 arthroscopic procedures were performed last year. Therefore, as the indications for arthroscopy increase and its use expands to joints other than the knee, it becomes necessary to ascertain any deleterious effects that the procedure may cause. Reagin et al1 evaluated several arthroscopic irrigating solutions and their effect on proteoglycan synthesis, using an in vitro system. They concluded that Ringer's lactate sustained chondrocyte function better than normal saline. As they pointed out, however, their study design may not be analogous to an in vivo situation, and its relevance could therefore be questioned.
Irrigation and distention of the joint capsule is obviously fundamental to any arthroscopic procedure. Stimulated by Reagin et al,1 the authors designed an animal model to determine the effect of irrigation with normal saline, Ringer's lactate, and sterile water on articular cartilage metabolism. The incorporation Of35SO4 has been used to determine proteoglycan synthesis and hence chondrocyte function. 1_5 By measuring the incorporation of 35SO4 after irrigation, the effect of the irrigants on articular cartilage activity could be determined. Sterile water was included since this solution has been recommended for use with intra-articular electrocautery devices.6
Materials and Methods
Thirty New Zealand white rabbits, weighing 1.5 kg to 2.5 kg were induced with 25 mg/kg Rompun (xylazine) given intramuscularly. General anesmesia was maintained with 1.5% to 2.0% Halothane by face mask technique.
Once anesthetized, the knees of the...