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Knee Surgery, Sports Traumatology, Arthroscopy

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01-07-2011 | Experimental Study

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

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

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2011

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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Title: The effect of Lidocaine on the viability of cultivated mature human cartilage cells: an in vitro study
Authors: Tom F. Jacobs
Pieter S. Vansintjan
Nathalie Roels
Sofie S. Herregods
Gust Verbruggen
Luc L. Herregods
Karl F. Almqvist
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1420-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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