Ural State Medical University; Ekaterinburg, Russian Federation.
*Corresponding author: Irina N. Kostina, PhD. Ural State Medical University, Ekaterinburg, Russian Federation. E-mail: kostinastom@yandex.ru
Published: June 22, 2014.
Objective: to study the morphological changes in cartilage after a single intra-articular betamethasone sodium phosphate (BSP)/betamethasone dipropionate (BDP) injection during the early stage of experimental osteoarthrosis (OA) of the temporomandibular joint (TMJ).
Material and Methods: The experiment was performed on 18 male rabbits aged 6 months .The first group consisted of 9 healthy rabbits. The second group included 9 rabbits with mechanically induced TMJ OA. For 5 days, 3 hours daily, a load (with a force of 200N) on the TMJ was imposed. In the left TMJ of the second group of rabbits, betamethasone was injected intra-articularly in different doses: 0.1 ml (n=3), 0.3 ml (n=3), and 0.5 ml (n=3). The right TMJ was used for comparison. A combined anesthesia was applied each experimental day. Rabbits of both groups were sacrificed on days 7, 14, and 30 with introductory combined anesthesia and intravenous injection of Zoletil 100® 20 mg/kg to stop their breathing.
Results: Betamethasone caused destruction of the chondrocytes, fragmentation of collagen fibers, deficit of proteoglycans (PGs) and glycosaminoglycans (GAGs), thinning of the cartilage, and contributed to the progression of TMJ OA.
Conclusion: The optimal dose of BSP/BDP for intra-articular injection in the early stages of TMJ OA must be within the range of 0.1-0.3 ml|0.7-1.5 mg.
1. Ravelli A, Martini A. Juvenile idiopathic arthritis. Lancet 2007; 369:767-78.
2. Hashkes PJ, Laxer RM. Medical treatment of juvenile idiopathic arthritis. JAMA 2005; 294:1671-84.
3. Wallace CA. Current management of juvenile idiopathic arthritis. Best Pract Res Clin Rheumatol 2006; 20:279-300.
4. Lanni S, Bertamino M, Consolaro A, Pistorio A, Magni-Manzoni S, Galasso R, et al. Outcome and predicting factors of single and multiple intra-articular corticosteroid injections in children with juvenile idiopathic arthritis. Rheumatology (Oxford) 2011; 50:1627-34.
5. Cleary AG, Murphy HD, Davidson JE. Intra-articular corticosteroid injections in juvenile idiopathic arthritis. Arch Dis Child 2003; 88:192-6.
6. Keen HI, Wakefield RJ, Hensor EM, Emery P, Conaghan PG. Response of symptoms and synovitis to intra-muscular methylprednisolone in osteoarthritis of the hand: an ultrasonographic study. Rheumatology (Oxford) 2010; 49:1093-100.
7. Arroll B, Goodyear-Smith F. Corticosteroid injections for osteoarthritis of the knee: meta-analysis. Br Med J 2004; 328:10.
8. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Intraarticular corticosteroid for treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006; 19:CD005328.
9. Uthman I, Raynauld J-P, Haraoui B. Intra-articular therapy in osteoarthritis. Postgrad Med J 2003; 79:449-53.
10. Creamer P. Intra-articular corticosteroid injections in osteoarthritis: do they work and if so, how? Ann Rheum Dis 1997; 56:634-6.
11. Filippucci E, Farina A, Carotti M, Salaffi F, Grassi W. Grey scale and power Doppler sonographic changes induced by intra-articular steroid injection treatment. Ann Rheum Dis 2004; 63:740-3.
12. Schueller-Weidekamm C, Krestan C, Schueller G, Kapral T, Aletaha D, Kainberger F. Power Doppler sonography and pulse-inversion harmonic imaging in evaluation of rheumatoid arthritis synovitis. Am J Roentgenol 2007;188:504-8.
13. Terslev L, Torp-Pedersen S, Qvistgaard E, Danneskiold-Samsoe B, Bliddal H. Estimation of inflammation by Doppler ultrasound: quantitative changes after intra-articular treatment in rheumatoid arthritis. Ann Rheum Dis 2003; 62:1049-53.
14. Caldwell JR. Intra-articular corticosteroids. Guide to selections and indications for use. Drugs 1996; 52:507-14.
15. Scott C, Meiorin S, Filocamo G, Lanni S, Valle M, Martinoli A. et al. A reappraisal of intra-articular corticosteroid therapy in juvenile idiopathic arthritis. Clin Exp Rheumatol 2010; 28:774-81.
16. Hetland ML, Stengaard-Pedersen K, Junker P, Lottenburger T, Hansen I, Andersen LS, et al. Aggressive combination therapy with intra-articular glucocorticoid injections and conventional disease-modifying anti-rheumatic drugs in early rheumatoid arthritis: second-year clinical and radiographic results from the CIMESTRA study. Ann Rheum Dis 2008; 67:815-22.
17. Pelletier JP, Haraoui B, Martel-Pelletier J. Modulation of cartilage degradation in arthritic diseases by therapeutic agents. In: Woessner JF., Howell DS. eds. Joint cartilage degradation. New York: Marcel Dekker. 1993: 503-28.
18. Pelletier JP, Martel-Pelletier J. Protective effects of corticosteroids on cartilage lesions and osteophyte formation in the Pond-Nuke dog model of osteoarthritis. Arthritis Rheum 1989; 32:181-93.
19. Pelletier JP, Mineau F, Raynauld JP, Gunia-Smitt Z, Martel-Pelletir J. Intraarticular injections with methylprednisolone acetate reduce osteoarthritic lesions in parallel with chondrocyte stromelysin synthesis in experimental osteoarthritis. Arthritis Rheum 1994; 37:414-23.
20. Karim Z, Quinn MA, Wakefield RJ, Bromn AK, Green MJ, Hensor EM. et al. Response to intramuscular methyl prednisolone in inflammatory hand pain: evidence for a targeted clinical, ultrasonographic and therapeutic approach. Ann Rheum Dis 2007; 66:690-2.
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Int J Biomed. 2014; 4(2):99-103. © 2014 International Medical Research and Development Corporation. All rights reserved.