CHONDROTOXICITY OF INTRA-ARTICULAR INJECTIONS OF LOCAL ANAESTHETICS AND
STEROIDS - DO WE HAVE A PROBLEM?(JUST ONE MORE THING TO WORRY ABOUT!)
Prof Vladimir Bobić, Consultant Orthopaedic Knee SurgeonChester Knee Clinic at Nuffield Health, The Grosvenor Hospital Chester
@ChesterKnee
11th Oswestry Cartilage SymposiumRJAH, Oswestry, 5th and 6th October 2017
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
… fast forward (2015):
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULAR INJECTIONS OF LOCAL ANAESTHETICS AND STEROIDS
VB CKC UK
… the stem cells are DOA!
CHONDROTOXICITY OF INTRA-ARTICULAR INJECTIONS OF LOCAL ANAESTHETICS AND STEROIDS
VB CKC UK
• Is this serious? Well, seems to be!
• Do we have a problem? Probably, but not at a litigation level. Well, not yet.
• My take home message is: if you have to inject LA after arthroscopy, don’t to it IA, but infiltrate around arthroscopic portals, 10ml max, with the lowest possible concentration (0.20 or 0.25 of whichever -caine). I use ropivacaine or Naropin.
• So, no panic but keep an eye on IA LA publications and: @ChesterKnee and @BioKneeSociety
• DMI? Tricky, tricky, as the cocktail of the usual LA + DM is injected IA. Use sparingly, if you have to.
• IA Steroids? A huge and controversial topic. Orthopaedics vs. OrthoBiologics! See you next year for the sequel!
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
THANK YOU FOR YOUR ATTENTION. TO BE CONTINUED …
CHONDROTOXICITY OF INTRA-ARTICULARINJECTIONS OF LOCAL ANAESTHETICS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULAR INJECTIONS OF LOCAL ANAESTHETICS AND STEROIDS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULAR INJECTIONS OF LOCAL ANAESTHETICS AND STEROIDS
VB CKC UK
CHONDROTOXICITY OF INTRA-ARTICULAR INJECTIONS OF LOCAL ANAESTHETICS AND
STEROIDS - DO WE HAVE A PROBLEM?(JUST ONE MORE THING TO WORRY ABOUT!)
Prof Vladimir Bobić, Consultant Orthopaedic Knee SurgeonChester Knee Clinic at Nuffield Health, The Grosvenor Hospital Chester
@ChesterKnee
11th Oswestry Cartilage SymposiumRJAH, Oswestry, 5th and 6th October 2017