title: Comparison of the effects of chronic intra-articular administration of tenoxicam, diclofenac, and methylprednisolone in healthy rats.
abstract: OBJECTIVE
  Lyophilized drug manufacturing and intra-articular (IA) applications have increased to address gastrointestinal side effects resulting from chronic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) for degenerative joint disease. Accordingly, we histologically examined joint and stomach tissues from rats to determine and compare the effects of long-term treatment with an IA corticosteroid (methylprednisolone acetate), lyophilized NSAID (tenoxicam), and non-lyophilized NSAID (diclofenac) following application to the knee joint.
  
  
  METHODS
  One hundred Wistar albino rats were divided into 4 groups of 25 rats: control, methylprednisolone, tenoxicam, and diclofenac. Ten IA injections were administered at 1-week intervals. Rats were sacrificed at 48 h and 1, 2, 4, and 8 weeks after the tenth injection. Histomorphologically, knee joint samples were examined for osteoarthritic changes and stomach tissue samples for gastric changes.
  
  
  RESULTS
  Unlike methylprednisolone, diclofenac and tenoxicam caused increased fibrosis and fibroblast production; furthermore, chronic methylprednisolone use had no negative effects on the synovium or cartilage.
  
  
  CONCLUSIONS
  Chronic tenoxicam and diclofenac use affects joints more negatively than chronic steroid treatment.
authors: Fatih Sultan Mehmet Training and Research Hospital, Department of Orthopaedics and Traumatology, İstanbul, Turkey. mehmetmufitorak@yahoo.com.
authors: Mehmet Müfit
authors: MM
authors: Orak
authors: Fatih Sultan Mehmet Training and Research Hospital, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
authors: Dursun
authors: D
authors: Ak
authors: Maltepe University Faculty of Medicine, Department of Pathology, İstanbul, Turkey.
authors: Ahmet
authors: A
authors: Midi
authors: Marmara University Faculty of Health Sciences, Department of Nursing, İstanbul, Turkey.
authors: Berna
authors: B
authors: Laçin
authors: İstanbul University, Faculty of Pharmacy, Department of Pharmaceutical Technology, İstanbul, Turkey.
authors: Sevim
authors: S
authors: Purisa
authors: Dr. Lütfi Kırdar Kartal Training and Research Hospital, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
authors: Güven
authors: G
authors: Bulut
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D002358:Cartilage, Articular / Q000473:pathology; D004008:Diclofenac / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D000077555:Methylprednisolone Acetate; D020370:Osteoarthritis, Knee / Q000473:pathology; D010894:Piroxicam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D051381:Rats; D017208:Rats, Wistar; D013270:Stomach / Q000473:pathology*; D013583:Synovial Membrane / Q000473:pathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D004008:Diclofenac; D000077555:Methylprednisolone Acetate; D008775:Methylprednisolone; C032801:tenoxicam