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Articular surface evaluation of sheep and horses subjected to articular irrigation with Ringer lactate at different temperatures

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Author(s):
Kaio Barros Bezerra
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Medicina Veterinária e Zootecnia (FMVZ/SBD)
Defense date:
Examining board members:
Luis Claudio Lopes Correia da Silva; Marcio Augusto Ferreira; Cristina de Oliveira Massoco Salles Gomes
Advisor: Luis Claudio Lopes Correia da Silva
Abstract

Arthroscopy has a diagnostic and a therapeutic function in joint disease. Even with modern imaging modalities, it is still considered the gold standard for diagnosing equine joint problems. It is known that the physicochemical characteristics of different infusion solutions could influence structural modifications on cartilage surface. A number of studies have described the search for the ideal fluid to be used for irrigation during arthroscopy, focusing on the biochemical characteristics of the various liquids. However, few works have taken temperature into consideration when studying the physical characteristics of these fluids. Therefore, in the first phase of this study four different temperatures of Ringer lactate used for articular irrigation were assessed into four groups of six ovine joints each (5, 12, 25 and 38 ºC). To evaluate each group, comparative synovial membrane and osteochondral samples were collected from the patellofemoral joints for histological analysis and Scanning Electron Microscopy, respectively, immediately before and 1 hour after starting fluid infusion. Ultrastructural changes of the joint surfaces after irrigation were observed, but no statistical differences between groups were identified. In the second phase of this study, lactated Ringers solution was assessed at three different temperatures: 5, 25 and 38°C, for irrigation of 12 radiocarpal joints of six horses during arthroscopy. Three groups of four joints were studied to evaluate synovial membrane, cartilage and synovial liquid immediately before and 12, 24 and 48 hours after joint irrigation. These samples were subjected to comparative analysis of IL-1&beta, PGE2, TNF-&alpha, condroitin sulfate (CS) and hyaluronic acid (HA) concentrations. Changes of equine joint surfaces were also independent of temperature. There was a significant increase in the PGE2 and IL-1β concentrations in the synovial liquid at 12 hours in all groups except for IL-1β on the joints irrigated with fluid at 38°C, which did not show concentrations changes. There was no statistical difference of TNF-&alpha between groups. CS concentrations had a significant increase at 24 hours in all groups, meanwhile in the 38 °C group this increased was statistically greater. There was no statistical difference for HA concentrations on synovial liquid of the irrigated joints at 25 °C. In the 5 and 38 °C groups there were synovial fluid HA decrease at 24 and 12 hours, respectively, returning to basal values at the subsequent collect. The synovial membrane biopsies collected in the both steps of this study did not show any structural alterations or cellular migration that might interfere in response to inflammatory insult. Ultrastructural changes in articular most superficial zone are more related to mechanic action of fluid lavage than irrigation solutions temperature. Although more tests needs to be done, the lowest concentrations of IL-1β in equine joints irrigated with Ringer lactate at 38 °C give some evidence that this is the less deleterious temperature to articular environment. (AU)

FAPESP's process: 12/07070-1 - Articular surface evaluation of sheep and horses submitted to joint infusion with ringer lactate solution at different temperatures
Grantee:Kaio Barros Bezerra
Support Opportunities: Scholarships in Brazil - Master