The Effect of Different Saline Suspension Height on Injured Articular Cartilage During Arthroscopic Surgery

ObjectiveSaline is typically suspended at a certain height to maintain a clear surgical field in arthroscopic surgery. The effects of saline on cartilage have been extensively studied; however, the impact of the pressure generated by saline solution suspended at different heights on injured cartilage is largely unknown. This study investigates suspension-height-dependent cellular responses and tissue damage in traumatized cartilage.MethodsOsteochondral explants were harvested from porcine stifle joints, then were cut perpendicularly before immersed or irrigated for 2 hours with saline at 4 heights (80/105/130/155 cm). The explants were then transferred to and cultured in chondrogenic medium for 5 days. Chondrocytes viability was subsequently assessed with confocal imaging. Cell response was assessed with expression levels of proapoptosis and proinflammatory genes. Tissue damage was evaluated by secretome analysis of proinflammatory cytokines and extracellular matrix and histological test.ResultsIrrigation exacerbated cut-induced chondrocytes death in superficial zone of cartilage, with mild change on 80 cm, 105 cm, 130 cm and severe damage on 155 cm. Similarly, explants that underwent irrigation with heights of 80 cm to 130 cm exhibited relatively slighter change of gene expression of BAX, BCL2, IL-6 and NOS2 and release of GAG, IL-6 and NO to a comparable extent.ConclusionThis study provides evidence of damaging effects of irrigation on injured cartilage surface. Suspension heights of 80 cm to 130 cm led to comparable minor cartilage damage.