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Home / Equine Research Bank / J Orthop Res / Repeated intraarticular injections of triamcinolone acetonid...
Journal of orthopaedic research : official publication of the Orthopaedic Research Society2004; 23(3); 602-610; doi: 10.1016/j.orthres.2004.10.003

Repeated intraarticular injections of triamcinolone acetonide alter cartilage matrix metabolism measured by biomarkers in synovial fluid.

Abstract: Although intraarticular (IA) corticosteroids are frequently used to treat joint disease, the effects of their repeated use on articular cartilage remains controversial. The aim of our study was to determine the effects of a clinically recommended dose of IA triamcinolone acetonide (TA), on synovial fluid (SF) biomarkers of cartilage metabolism. Ten adult horses, free of osteoarthritis (OA) in their radiocarpal joints, were studied. One radiocarpal joint of each horse was randomly chosen for treatment and the contralateral anatomically paired joint acted as the control. Aseptic arthrocentesis was performed weekly on both joints for 13 weeks. The initial results from the first 3 weeks of the experimental period established baseline untreated control marker levels for each joint, each being its own control. On weeks 3, 5, and 7, a sterile suspension of 12 mg of TA was injected into the treated joint and an equivalent volume of sterile saline solution (0.9%) was injected into the control joint. SF was immunoassayed for biomarkers of aggrecan turnover (CS 846 & KS), types I and II collagen cleavage (C1,2C) and type II collagen synthesis (CPII). In treated joints, there was a significant increase in CS 846, KS, C1,2C and CPII epitope concentrations following IA TA injections when compared to baseline levels. There was also a significant increase in C1,2C and CPII epitope concentrations in the contralateral control joints following IA TA injections in the treated joint. Significant differences were observed between treated and control joints for all markers except CPII. These findings indicate that TA alters articular cartilage and collagen metabolism in treated and, interestingly, also in control joints, suggesting a systemic effect of the drug. Though intuitively the observed findings would favor the hypothesis that long-term IA TA treatment changes joint metabolism and this may have detrimental effects; further studies would be necessary to confirm this.
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Publication Date: 2004-12-21 PubMed ID: 15885481DOI: 10.1016/j.orthres.2004.10.003Google Scholar: Lookup
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article explores the effects of repeated use of triamcinolone acetonide, a corticosteroid, on joint health. This was studied by examining changes in biomarkers of cartilage metabolism in the synovial fluid, indicating that the drug may have both local and systemic effects.

Objective of the Study

  • The main aim of the research was to understand the impact of intraarticular triamcinolone acetonide (IA TA), a corticosteroid frequently used in joint diseases, on the health of articular cartilage, more specifically on the biomarkers of cartilage metabolism in synovial fluid.

Research Methodology

  • The study involved ten adult horses with radiocarpal joints free of osteoarthritis.
  • Each horse’s one joint was selected for treatment and the other paired joint acted as a control.
  • Every week for 13 weeks, aseptic arthrocentesis, a medical procedure in which synovial fluid is collected from a joint, was conducted on both types of joints.
  • Beginning from the third week, the treated joint received 12mg of sterile IA TA and the control joint received an equal volume of saline solution during the 3rd, 5th, and 7th weeks.
  • Biomarkers specific to aggrecan turnover (CS 846 & KS), types I and II collagen cleavage (C1,2C), and type II collagen synthesis (CPII) in the collected synovial fluid were then examined using immunoassay techniques.

Findings of the Study

  • Research found a significant increase in the concentrations of CS 846, KS, C1,2C, and CPII epitopes in treated joints after the administration of IA TA when compared with the baseline concentrations.
  • A significant increase was also observed in the concentrations of C1,2C and CPII epitope in the control joints following IA TA injections in the treated joint.
  • All biomarkers, except for CPII, displayed significant differences between the treated and control joints.
  • The findings suggest that IA TA affected both the cartilage and collagen metabolism in the treated joints, and surprisingly, also in the control joints, hence indicating a systemic impact of the drug.

Conclusion

  • The researchers concluded that the observed effects hint towards long-term IA TA treatment altering joint metabolism, which could potentially have adverse effects.
  • However, they noted that further studies would be necessary to confirm these findings and fully understand the long-term effects of IA TA on joints.

Cite This Article

APA
Céleste C, Ionescu M, Robin Poole A, Laverty S. (2004). Repeated intraarticular injections of triamcinolone acetonide alter cartilage matrix metabolism measured by biomarkers in synovial fluid. J Orthop Res, 23(3), 602-610. https://doi.org/10.1016/j.orthres.2004.10.003

Publication

Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 0736-0266
NlmUniqueID: 8404726
Country: United States
Language: English
Volume: 23
Issue: 3
Pages: 602-610

Researcher Affiliations

Céleste, Christophe
  • Département des Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Que., Canada.
Ionescu, Mirela
    Robin Poole, A
      Laverty, Sheila

        MeSH Terms

        • Aggrecans
        • Animals
        • Biomarkers
        • Cartilage, Articular / drug effects
        • Cartilage, Articular / metabolism
        • Collagen Type II / analysis
        • Collagen Type II / metabolism
        • Epitopes
        • Extracellular Matrix Proteins / analysis
        • Female
        • Horses
        • Injections, Intra-Articular
        • Keratan Sulfate / analysis
        • Lectins, C-Type
        • Male
        • Metalloproteases / antagonists & inhibitors
        • Metalloproteases / genetics
        • Proteoglycans / analysis
        • Synovial Fluid / chemistry
        • Triamcinolone Acetonide / administration & dosage
        • Triamcinolone Acetonide / pharmacology

        Citations

        This article has been cited 22 times.
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