Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 19, Issue 12, pp 2138–2144

Bupivacaine, ropivacaine, and morphine: comparison of toxicity on human hamstring-derived stem/progenitor cells

  • Florian Haasters
  • Hans Polzer
  • Wolf Christian Prall
  • Maximilian Michael Saller
  • Julia Kohler
  • Stefan Grote
  • Wolf Mutschler
  • Denitsa Docheva
  • Matthias Schieker
Experimental Study

DOI: 10.1007/s00167-011-1564-3

Cite this article as:
Haasters, F., Polzer, H., Prall, W.C. et al. Knee Surg Sports Traumatol Arthrosc (2011) 19: 2138. doi:10.1007/s00167-011-1564-3

Abstract

Purpose

Bupivacaine, ropivacaine, and morphine are commonly administered intraarticularly after anterior cruciate ligament (ACL) reconstruction. However, their effects on human tendon stem/progenitor cells (TSPC) have not been studied. Therefore, this study investigates the cytotoxicity of these analgetics on TSPC.

Methods

Cells were isolated from human hamstring grafts of 3 female (age 15, 16 and 59) and 2 male patients (age 16 and 47). Cells were incubated using 0.5% bupivacaine, 0.5/0.75% ropivacaine, and 0.025% morphine. Cell viability was assessed after 0.5, 2, and 6 h using live/dead assay. Metabolic activity and apoptosis were measured by WST- and Annexin-V-FACS-assay after 2 h.

Results

Cell viability remained unchanged after 0.5 h in all groups, while treatment with bupivacaine and 0.5/0.75% ropivacaine resulted in a complete cell loss after 6 h. Contrarily, morphine showed no cytotoxic effect. Cell viability and metabolism were significantly reduced after treatment with bupivacaine (22.1; 8.3%) and 0.75% ropivacaine (56.5; 23.8%), while 0.5% ropivacaine and morphine showed no significant difference compared with controls. Apoptosis was significantly induced after incubation with bupivacaine (58.1%) and 0.75% ropivacaine (26.2%), whereas 0.5% ropivacaine only led to a slight induction compared with morphine and controls.

Conclusions

Clinically administered concentrations of bupivacaine (0.5%) and ropivacaine (0.75%) have a significant cytotoxic effect on human TSPC in vitro, while ropivacaine in a concentration of 0.5% has a mild but not significant effect on apoptosis and cell metabolism. In contrast, morphine does not affect cell survival, metabolism, or apoptosis. Knowing that morphine provides comparable to even prolonged pain reduction after ACL reconstruction, the presented in vitro study suggests morphine as a potentially less toxic analgetic drug for intraarticular application in clinical practice.

Keywords

Human tendon stem/progenitor cells (TSPC) Local anesthetics Intraarticular administration Toxicity Anterior cruciate ligament (ACL) reconstruction 

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Florian Haasters
    • 1
  • Hans Polzer
    • 1
  • Wolf Christian Prall
    • 1
  • Maximilian Michael Saller
    • 1
  • Julia Kohler
    • 1
  • Stefan Grote
    • 1
  • Wolf Mutschler
    • 1
  • Denitsa Docheva
    • 1
  • Matthias Schieker
    • 1
  1. 1.Experimental Surgery and Regenerative Medicine, Department of SurgeryLudwig-Maximilians-University MunichMunichGermany

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