| Abstract ID |
| 20260128 |
| Category |
| Basic Science and Biologic Repair |
| Preferable Presentation |
| Oral Presentation |
| Title |
| ANTI-INFLAMMATORY EFFECTS AND CELLULAR SAFETY OF SODIUM HYALURONATE, SODIUM HYALURONATE PLUS MANNITOL, AND TRIAMCINOLONE ACETONIDE FOR INTRA-ARTICULAR INJECTION IN SPORTS MEDICINE: AN IN VITRO STUDY |
| Author |
|
| Presenter |
| Chaiwat Chuaychoosakoon |
| Abstract |
| Background: Intra-articular injections are frequently used in sports medicine to manage joint inflammation and pain in athletes, particularly following acute injury or repetitive mechanical stress. Triamcinolone acetonide is commonly administered for rapid suppression of inflammation, whereas hyaluronic acid formulations are used to support joint homeostasis and preserve intra-articular tissue biology. In these clinically active joints, synovial inflammation is closely linked to macrophage activation and is a key contributor to pain and functional impairment. However, comparative data integrating anti-inflammatory efficacy with intra-articular cellular safety, especially in biologically active joints of athletes, remain limited. Purpose: To compare the anti-inflammatory effects and intra-articular cellular safety of sodium hyaluronate, sodium hyaluronate combined with mannitol, and triamcinolone acetonide using inflammatory mediator assessment and viability analysis in clinically relevant cell types. Methods: An in vitro experimental study was conducted. Macrophage-mediated inflammatory activity was induced using lipopolysaccharide stimulation, and nitric oxide production was measured as a surrogate marker of inflammatory response. Sodium hyaluronate, sodium hyaluronate plus mannitol, and triamcinolone acetonide were evaluated across clinically relevant concentrations. Intra-articular cellular safety was assessed using viability assays in human tenocytes and human mesenchymal stem cells at 24 hours. Results were compared with untreated controls using appropriate statistical analyses. Results: Lipopolysaccharide stimulation significantly increased nitric oxide production, confirming successful induction of an inflammatory state. Sodium hyaluronate, sodium hyaluronate combined with mannitol, and triamcinolone acetonide each significantly suppressed inflammatory mediator production, with no significant differences among treatment groups. In terms of intra-articular cellular safety, sodium hyaluronate and sodium hyaluronate plus mannitol consistently increased tenocyte and mesenchymal stem cell viability across all concentrations. In contrast, triamcinolone acetonide caused a significant, dose-dependent reduction in tenocyte and mesenchymal stem cell viability at 24 hours, indicating cytotoxic effects on regenerative cells. Conclusions: Although sodium hyaluronate, sodium hyaluronate plus mannitol, and triamcinolone acetonide demonstrate comparable suppression of inflammatory mediators, their intra-articular cellular safety profiles differ substantially. In a sports medicine context, where preservation of regenerative capacity is important for athletic performance and recovery, hyaluronic acid formulations demonstrate a more favorable biologic profile, whereas triamcinolone acetonide exhibits cytotoxic effects on intra-articular regenerative cells that may render it less suitable for repeated use in active joints. |