Abstract
Tribological surgical adjuvants constitute a therapeutic discipline made possible by surgical advances in the treatment of damaged articular cartilage beyond palliative care. The purpose of this study is to analyze interactions between hyaluronic acid and phospholipid molecules, and the formation of geometric forms, that play a role in the facilitated lubrication of synovial joint organ systems. The analysis includes an evaluation of the pathologic state to detail conditions that may be encountered by adjuvants during surgical convalescence. The synovial fluid changes in pH, hyaluronic acid polydispersity, and phospholipid concentration associated with osteoarthritis are presented as features that influence the lubricating properties of adjuvant candidates. Molecular dynamic simulation studies are presented, and the Rouse model is deployed, to rationalize low molecular weight hyaluronic acid behavior in an osteoarthritic environment of increased pH and phospholipid concentration. The results indicate that the hyaluronic acid radius of gyration time evolution is both pH- and phospholipid concentration-dependent. Specifically, dipalmitoylphosphatidylcholine induces hydrophobic interactions in the system, causing low molecular weight hyaluronic acid to shrink and at high concentration be absorbed into phospholipid vesicles. Low molecular weight hyaluronic acid appears to be insufficient for use as a tribological surgical adjuvant because an increased pH and phospholipid concentration induces decreased crosslinking that prevents the formation of supramolecular lubricating forms. Dipalmitoylphosphatidylcholine remains an adjuvant candidate for certain clinical situations. The need to reconcile osteoarthritic phenotypes is a prerequisite that should serve as a framework for future adjuvant design and subsequent tribological testing.
Highlights
Synovial joint organ system lubrication is a complex process influenced by mechanical, molecular, and fluid factors toward wear reduction and tissue homeostasis
Because surgical advances have this perturbation molecular layer be normalized to enhance tissue rescue while pathologic phenotypes may enabled the non-palliative repair of damaged cartilage surfaces without producing iatrogenic persist post-treatment [2]? Though knowledge of osteoarthritis’ phenotype spectrum appears ever collateral tissue necrosis, an interest in normalizing this molecular lubricating layer has emerged as increasing
Red depicts oxygen atoms localized at hydrophilic DPPC head groups
Summary
Synovial joint organ system lubrication is a complex process influenced by mechanical, molecular, and fluid factors toward wear reduction and tissue homeostasis. An effective lubricating molecular layer is formed between juxtaposed articular cartilage surfaces. Both structural and compositional changes in this layer can lead to aberrant lubrication, ineffective perturbation mitigation, and progressive system dysfunction. Because surgical advances have this perturbation molecular layer be normalized to enhance tissue rescue while pathologic phenotypes may enabled the non-palliative repair of damaged cartilage surfaces without producing iatrogenic persist post-treatment [2]? Though knowledge of osteoarthritis’ phenotype spectrum appears ever collateral tissue necrosis, an interest in normalizing this molecular lubricating layer has emerged as increasing [3], this study is designed as a framework to evaluate synovial fluid conditions that adjuvant the therapeutic discipline of tribological surgical adjuvants [1]. A confounding question lingers: candidates encounter duringlayer surgical convalescence
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