Journal of Cartilage & Joint Preservation · Published 2025-05-16 · DOI 10.1016/j.jcjp.2025.100247
ABSTRACT: Introduction: Hurricane Helene in September 2024 disrupted saline distribution, causing a months-long shortage in US hospitals. Saline is essential for irrigation in orthopedic procedures, including arthroscopy. While alternatives such as lactated Ringer’s and multielectrolyte solutions have gained attention, evidence comparing their safety and efficacy to saline remains limited. Objectives: To evaluate the effect of saline, lactated Ringer’s, and multielectrolytes solution on chondrocyte viability and extracellular matrix release in an in vitro osteochondral (OC) explant model. Methods: OC explants (6×10mm) were harvested from OC allograft remnants and tested with saline, lactated Ringer’s, and a multielectrolytes solution. Explants were incubated in each solution (1 hour, 37 °C), then analyzed for chondrocyte viability and gene expression, while the conditioned supernatant was assessed for glycosaminoglycan release. Additional explants were flushed with one of the solutions using a syringe and 18-gauge needle to simulate pulse lavage, followed by chondrocyte viability analysis. Results: No significant differences in chondrocyte viability were observed across the 3 solutions (P>.90). Compared to saline, gene expression analysis showed lactated Ringer’s reduced MMP13, COL2A1, and IL6, though not significantly, while the multielectrolytes significantly reduced all 3 (P<.001). No significant differences were found between lactated Ringer’s and multielectrolytes. Glycosaminoglycan release was similar across the 3 solutions. Conclusions: Neither lactated Ringer’s nor multielectrolytes solution caused increased chondrocyte death or cartilage damage compared to saline in this in vitro model, both for incubation and bone marrow flushing. These solutions may be viable alternatives for preserving cartilage integrity in orthopedic procedures.
Abstract from DOAJ. Public domain (CC0 1.0).
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