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Full\u2010thickness cartilage explants (n\u00a0= 72, Outerbridge grade 1 to 3) were created and bisected. Paired explant halves were treated with either 1 mL Orthococktail or 1 mL of saline and cultured for 8 hours at 37\u00b0C, with 0.5 mL of the treatment being removed and replaced with tissue culture media every hour. Explants were cultured for 6 days, and media were changed and collected on days 3 and 6. After day 6, tissues were processed for cell viability, weighed, and processed for histologic grading. Outcome measures were compared for significant differences between treated and untreated samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were no significant differences in cartilage viability between control and Orthococktail\u2010treated samples across a spectrum of cartilage pathologies. Orthococktail treatment consistently resulted in a significant decrease in the release of PGE2, MCP\u20101, MMP\u20107, and MMP\u20108 on day 3 of culture and PGE2, MMP\u20103, MMP\u20107, and MMP\u20108 on day 6 of culture, compared with saline controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of the present study indicate that an Orthococktail injection composed of morphine, ropivacaine, epinephrine, and ketorolac is associated with a transient decrease in degradative and inflammatory mediators produced by more severely affected articular cartilage and may mitigate perioperative joint pain such that postoperative narcotic drug use could be reduced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>The Orthococktail solution used in this study may be a safe intraoperative, intra\u2010articular injection option for patients undergoing joint arthroplasty and other joint preservation surgical procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2021.12.019","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T21:08:13Z","timestamp":1640120893000},"page":"1980-1995","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["An Injectable Containing Morphine, Ropivacaine, Epinephrine, and Ketorolac Is Not Cytotoxic to Articular Cartilage Explants From Degenerative Knees"],"prefix":"10.1002","volume":"38","author":[{"given":"John R.","family":"Baumann","sequence":"first","affiliation":[{"name":"Thompson Laboratory for Regenerative Orthopaedics University of Missouri Columbia Missouri U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron 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