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

TOM JACOBS (UGent) , PIETER VANSINTJAN (UGent) , NATHALIE ROELS (UGent) , Sofie Herregods, August Verbruggen (UGent) , Luc Herregods (UGent) and Karl Almqvist (UGent)
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Abstract
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. 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. 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. 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.
Keywords
Chondrocytes, Lidocaine, Toxic effect, Intra-articular, TOXICITY, CHONDROTOXICITY, INFUSION, ANALGESIA, ROPIVACAINE, CHONDROLYSIS, SHOULDER SURGERY, 0.5-PERCENT BUPIVACAINE, HUMAN ARTICULAR CHONDROCYTES, LOCAL-ANESTHETICS

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MLA
JACOBS, TOM, PIETER VANSINTJAN, NATHALIE ROELS, et al. “The Effect of Lidocaine on the Viability of Cultivated Mature Human Cartilage Cells: An in Vitro Study.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 19.7 (2011): 1206–1213. Print.
APA
JACOBS, TOM, VANSINTJAN, P., ROELS, N., Herregods, S., Verbruggen, A., Herregods, L., & Almqvist, K. (2011). The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 19(7), 1206–1213.
Chicago author-date
JACOBS, TOM, PIETER VANSINTJAN, NATHALIE ROELS, Sofie Herregods, August Verbruggen, Luc Herregods, and Karl Almqvist. 2011. “The Effect of Lidocaine on the Viability of Cultivated Mature Human Cartilage Cells: An in Vitro Study.” Knee Surgery Sports Traumatology Arthroscopy 19 (7): 1206–1213.
Chicago author-date (all authors)
JACOBS, TOM, PIETER VANSINTJAN, NATHALIE ROELS, Sofie Herregods, August Verbruggen, Luc Herregods, and Karl Almqvist. 2011. “The Effect of Lidocaine on the Viability of Cultivated Mature Human Cartilage Cells: An in Vitro Study.” Knee Surgery Sports Traumatology Arthroscopy 19 (7): 1206–1213.
Vancouver
1.
JACOBS T, VANSINTJAN P, ROELS N, Herregods S, Verbruggen A, Herregods L, et al. The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2011;19(7):1206–13.
IEEE
[1]
T. JACOBS et al., “The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study,” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, vol. 19, no. 7, pp. 1206–1213, 2011.
@article{1851626,
  abstract     = {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.
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.
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.
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.},
  author       = {JACOBS, TOM and VANSINTJAN, PIETER and ROELS, NATHALIE and Herregods, Sofie and Verbruggen, August and Herregods, Luc and Almqvist, Karl},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keywords     = {Chondrocytes,Lidocaine,Toxic effect,Intra-articular,TOXICITY,CHONDROTOXICITY,INFUSION,ANALGESIA,ROPIVACAINE,CHONDROLYSIS,SHOULDER SURGERY,0.5-PERCENT BUPIVACAINE,HUMAN ARTICULAR CHONDROCYTES,LOCAL-ANESTHETICS},
  language     = {eng},
  number       = {7},
  pages        = {1206--1213},
  title        = {The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study},
  url          = {http://dx.doi.org/10.1007/s00167-011-1420-5},
  volume       = {19},
  year         = {2011},
}

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