Experimental Study on Protective Role of NSAID on Articular Cartilage Destruction in Septic Arthritis

Abstract

Background: Surgical drainage and antibiotic therapy are the cornerstones of treatment protocols in septic arthritis; however, in some circumstances, the diagnosis and initiation of treatment may be retarded by slow disease progression or the time when the patient's condition precludes early surgery. Therefore, it is beneficial to find ways to reduce the amount of articular injury. This study aimed to evaluate the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the prevention of articular cartilage damage in an animal model of staphylococcal septic arthritis.<br />Methods: Knee joints of 40 rabbits were infected by the intra-articular injection of 105 colony-forming units of Staphylococcus aureus. Subsequently, they were categorized into four groups. The first (i.e., control group) and second groups were treated with a placebo and intramuscular injection of Ceftriaxone, respectively. Moreover, the third and fourth groups were treated with Naproxen alone and a combination of Ceftriaxone and Naproxen, respectively. All medications were started 24 h after the inoculation of microorganisms into the knee joint and continued for 3 days. Following that, the cartilage was evaluated using the International Cartilage Repair Society (ICRS) Visual Histological Assessment Scale.<br />Results: The group treated with the combination of Ceftriaxone and Naproxen obtained better results in terms of cell viability in tibial side cartilage and surface in both tibial and femoral cartilages (P<0.0125), compared to the group treated with antibiotics alone.<br />Conclusion: According to the results, in case of septic arthritis, the early administration of NSAID in conjunction with an appropriate systemic antibiotic may decrease further articular cartilage damage that is evoked by an infection.<br />Level of evidence: III