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Published on: May 26, 2023
The chondrotoxicity of single-dose corticosteroids
Jason L Dragoo1, Christina M Danial, Hillary J Braun
1Department of Orthopaedic Surgery, Stanford University, 450 Broadway Street, Pavilion C, 4th Floor, Redwood City, CA 94063-6342, USA. jdragoo@stanford.edu
Summary
Betamethasone injections significantly harm human chondrocytes, causing cell death in vitro. Triamcinolone acetonide also showed chondrotoxicity, indicating caution is needed with these corticosteroid treatments.
Area of Science:
- Orthopedics
- Cell Biology
- Pharmacology
Background:
- Intra-articular corticosteroid injections are common for joint pain.
- The chondrotoxicity of single-injection doses has not been extensively studied.
- Understanding corticosteroid effects on chondrocytes is crucial for joint health.
Purpose of the Study:
- To evaluate the in vitro chondrotoxicity of single-injection doses of common corticosteroids.
- Specifically assessed dexamethasone sodium phosphate, methylprednisolone acetate, betamethasone sodium phosphate/acetate, and triamcinolone acetonide.
- Determined the impact on human chondrocyte viability.
Main Methods:
- Human chondrocytes were exposed to single-injection doses of four corticosteroids in a bioreactor.
- A continuous infusion pump mimicked joint fluid metabolism.
- Chondrocyte viability was quantified using a live/dead assay over average drug duration and a 14-day period.
Main Results:
- Betamethasone sodium phosphate/acetate and triamcinolone acetonide significantly reduced chondrocyte viability over their average duration of action.
- In a 14-day trial, only betamethasone sodium phosphate/acetate caused a significant decrease in chondrocyte viability compared to controls.
- These findings highlight differential chondrotoxic effects among corticosteroids.
Conclusions:
- Betamethasone sodium phosphate and betamethasone acetate demonstrated consistent and significant chondrotoxicity in a physiologically relevant in vitro model.
- Triamcinolone acetonide showed evidence of chondrotoxicity in a single trial.
- Betamethasone sodium phosphate/acetate was the only agent causing significant cell death at 14 days, warranting cautious use.
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