Intra-articular Adenosine, Lidocaine and Magnesium (ALM) solution decreases postoperative joint fibrosis in an experimental knee implant model

Abstract Background There is currently no drug therapy to prevent arthrofibrosis following knee surgery. We aimed determine if the anti-ischemic and anti-inflammatory adenosine, lidocaine Mg 2+ (ALM), reduces surgery-related in a rat model of implant Methods Male Sprague-Dawley rats ( n = 24) were randomly divided into ALM or saline groups. The right each animal was implanted with custom titanium (femur) polyethylene (tibia) implants, left served as non-operated control. An intra-articular bolus (0.1 ml) administered at end surgery, animals monitored for 4 weeks. Fibrotic changes assessed by macroscopic examination, histopathology, expression key inflammatory fibrotic markers joint capsule infrapatellar fat pad (IFP). Results Knee swelling evident both groups However, range motion 2-fold higher ALM-treated knees, differences pathology indicated improved healing, compared control group. Histologically, treatment also led significantly decreased synovitis IFP controls. RNA protein profiles pro-fibrotic mediators (α-SMA, TGF-β1, FGF1, PDGFA) lower knees from animals. In addition, plasma (IL-1β, IL-10) tissue (NFκB, IL-1β, IL-12), weeks after Conclusion show that administration single an experimental blunting inflammation modulating essential genes fibrosis. has therapeutic potential translation humans undergoing replacement