Cartilage damage

Higher dose amoxicillin, amoxicillin-davulanate (eg., 90 mg/kg/day) is used for penicillin-resistant Streptococcus pneumoniae fluoroquinolones are avoided in pediatric patients because of the potential for cartilage damage however, their use in pediatrics is emerging. Doses shown are extrapolated from adults and will require further study. 

ARRY-438162 was found to be efficacious in a number of animal models of inflammation. For example, in a collagen-induced arthritis model in rats, oral administration of ARRY-438162 at lOmg/kg q.d. significantly inhibited paw swelling which was accompanied by inhibition of cartilage damage in the joint and >80% inhibition of pERK in the tissue from the foot with induced arthritis. 

Fluoroquinolones are well tolerated. The most common adverse effects are nausea, vomiting, diarrhoea, headache, insomnia, skin rash and occasionally abnormal liver function tests (with trovafloxacin). Phototoxicity has been particularly reported with pefloxacin, lomefloxacin, sparfloxacin and ofloxacin. Tendinitis is a serious side effect rarely reported in adults. Because of cartilage damage in children it must be used under close supervision. 

K24. Kowanko, I. C., Bates, E. J., and Ferrante, A., Mechanisms of human neutrophil-mediated cartilage damage in vitro The role of lysosomal enzymes, hydrogen peroxide and hypochlorous acid. Immunol. Cell Biol. 67,321—329 (1989). 

Cartilage culturing service Carticel (Genzyme) Cartilage damage in knees... 

Arthropathy has been reported with various fluoroquinolones, particularly in children. In a Russian study in children with cystic fibrosis five were withdrawn (four taking ciprofloxacin and one taking pefloxacin) (94). Two had an arthropathy that was drug- and age-dependent. Quinolone-induced arthropathy was more common with pefloxacin and occurred only in children over 10 years old with a history of joint problems. The arthropathy fully recovered within 7 days to 3 months and there was no cartilage damage. 

The quinolone antibiotic enrofloxacin has been found to cause articular cartilage damage in neonatal foals similar to that found in immature animals of other species (Vivrette 2001). Safety studies investigating the effects of enrofloxacin therapy in pregnant mares on the articular cartilage of fetal foals have not been performed therefore, caution should be exercised in the use of this antibiotic (see Ch. 2). 

Kowanko IC, Ferrante A. Adhesion and TNF priming in neutrophil-mediated cartilage damage. Clin Immuno Immunopathol 1996 79 36-42. 

FIGURE 50.7 Cartilage damage produced by sliding contact... 

PAMAM G4 Nitroxide Nitroxide Nitroxide Cartilage damage MRI Yes Yes 391... 

The optimum location for the FAM portal during ACL reconstruction should avoid cartilage damage to the medial femoral condyle. This portal is usually created just above the medial meniscus and approximately 2.5 cm medial to the medial border of the patellar tendon. Using preoperative three-dimensional computed... 

Siebold R, Benetos IS, Sartory N, He Z, Hariri N, Passler HH (2010) How to avoid the risk of intraoperative cartilage damage in anatomic four tunnel double bundle anterior craciate ligament reconstmction. Knee Surg Sports Traumatol Arthrosc 18(1) 64—67... 

Zantop T, Haase AK, Fu FH, Petersen W (2008) Potential risk of cartilage damage in double bundle ACL reconstruction impact of knee flexion angle and portal location on the femoral PL bundle turmel. Arch Orthop Trauma Surg 128(5) 509-513... 

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