title: Effects on exposed articular cartilage during open surgical procedures: a comparison of various fluids in an animal model.
abstract: OBJECTIVE
  The aim of this study was to assess the potential detrimental effects of the operating room environment on exposed healthy articular cartilage and to evaluate tissue hydration treatment strategies for preserving chondrocyte viability and extracellular matrix composition in this environment.
  
  
  METHODS
  With institutional Animal Care and Use Committee approval, femoral and tibial condyles (n = 36; 6 per specimen) were harvested from canine cadavers (n = 6) immediately after euthanasia and placed on a draped operating table under standard surgical lighting for a timed 2-hour period. Each condyle was randomly assigned to one of 6 groups (n = 6 per group): no-treatment control, hyaluronic acid (HA), saline sponge, saline drip, culture media (Dulbecco's modified Eagle's medium [DMEM]) sponge, or culture media drip. Full-thickness cartilage sections were collected from each specimen immediately after harvest (time 0) and immediately after 2-hour exposure (time 2H), and processed to determine chondrocyte viability, tissue water content, and extracellular matrix composition (glycosaminoglycan [GAG] and collagen content).
  
  
  RESULTS
  Chondrocyte viability was significantly lower (P = .03) after the 2-hour exposure in the control group. HA, saline sponge, and saline drip treatment groups all had significantly higher (P < .043) chondrocyte viability compared with controls at time 2H. Water content was significantly lower (P < .01) after the 2-hour exposure in the control group. Further, the water content in the control group was significantly lower than all treatment groups at time 2H (P < .001). No significant differences in tissue collagen or GAG content were observed within groups between time points or among groups at either time point.
  
  
  CONCLUSIONS
  Canine articular cartilage did not demonstrate any reduction in chondrocyte viability or tissue water content at 2 hours when treated with hyaluronic acid, saline drip, saline-soaked sponge, or DMEM-soaked sponge compared with untreated exposed cartilage.
  
  
  CONCLUSIONS
  Surgeons should consider the use of a hydrating solution for the treatment of exposed articular cartilage during open joint surgery of 2 hours or longer duration.
authors.affiliation: Indiana University School of Medicine, OrthoIndy Cartilage Restoration Center, Indianapolis, Indiana, U.S.A.
authors.forename: Jack
authors.initials: J
authors.lastname: Farr
authors.affiliation: Comparative Orthopaedic Laboratory, Columbia, Missouri, U.S.A.
authors.forename: Leanne M
authors.initials: LM
authors.lastname: Mathew
authors.affiliation: Comparative Orthopaedic Laboratory, Columbia, Missouri, U.S.A.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Stoker
authors.affiliation: Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A.
authors.forename: Seth L
authors.initials: SL
authors.lastname: Sherman
authors.affiliation: Comparative Orthopaedic Laboratory, Columbia, Missouri, U.S.A.; Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A.. Electronic address: cookjl@health.missouri.edu.
authors.forename: James L
authors.initials: JL
authors.lastname: Cook
mesh_terms: D000818:Animals; D001834:Body Water; D002358:Cartilage, Articular / Q000737:chemistry / Q000166:cytology / Q000187:drug effects; D002470:Cell Survival; D019902:Chondrocytes / Q000166:cytology; D003094:Collagen / Q000032:analysis; D003470:Culture Media; D004285:Dogs; D004781:Environmental Exposure / Q000009:adverse effects*; D005109:Extracellular Matrix; D006025:Glycosaminoglycans / Q000032:analysis; D006820:Hyaluronic Acid / Q000008:administration & dosage; D008029:Lighting; D008297:Male; D023421:Models, Animal; D009873:Operating Rooms; D011897:Random Allocation; D012965:Sodium Chloride; D015503:Surgical Sponges; D013997:Time Factors
chemical_list: D003470:Culture Media; D006025:Glycosaminoglycans; D012965:Sodium Chloride; D006820:Hyaluronic Acid; D003094:Collagen