Synovial Constituents Research Articles

Brushing Up on Cartilage Lubrication: Polyelectrolyte-Enhanced Tribological Rehydration.

This study presents new insights into the potential role of polyelectrolyte interfaces in regulating low friction and interstitial fluid pressurization of cartilage. Polymer brushes composed of hydrophilic 3-sulfopropyl methacrylate potassium salt (SPMK) tethered to a PEEK substrate (SPMK-g-PEEK) are a compelling biomimetic solution for interfacing with cartilage, inspired by the natural lubricating biopolyelectrolyte constituents of synovial fluid. These SPMK-g-PEEK surfaces exhibit a hydrated compliant layer approximately 5 μm thick, demonstrating the ability to maintain low friction coefficients (μ ∼ 0.01) across a wide speed range (0.1-200 mm/s) under physiological loads (0.75-1.2 MPa). A novel polyelectrolyte-enhanced tribological rehydration mechanism is elucidated, capable of recovering up to ∼12% cartilage strain and subsequently facilitating cartilage interstitial fluid recovery, under loads ranging from 0.25 to 2.21 MPa. This is attributed to the combined effects of fluid confinement within the contact gap and the enhanced elastohydrodynamic behavior of polymer brushes. Contrary to conventional theories that emphasize interstitial fluid pressurization in regulating cartilage lubrication, this work demonstrates that SPMK-g-PEEK's frictional behavior with cartilage is independent of these factors and provides unabating aqueous lubrication. Polyelectrolyte-enhanced tribological rehydration can occur within a static contact area and operates independently of known mechanisms of cartilage interstitial fluid recovery established for converging or migrating cartilage contacts. These findings challenge existing paradigms, proposing a novel polyelectrolyte-cartilage tribological mechanism not exclusively reliant on interstitial fluid pressurization or cartilage contact geometry. The implications of this research extend to a broader understanding of synovial joint lubrication, offering insights into the development of joint replacement materials that more accurately replicate the natural functionality of cartilage.

In Situ Observation of Hyaluronan Molecular Weight Effectiveness within Articular Cartilage Lubrication

Degradation of the articular cartilage (AC) structure due to osteoarthritis significantly influences its friction and lubrication mechanisms. Injection with exogenous hyaluronic acid (HA) is one of the ways to slow down the progress of these changes. The present paper aims to determine the effect of HA on the friction and lubrication processes of the synovial joint model. The main emphasis is placed on the effect of HA molecular weight (MW) on the coefficient of friction (COF) and the interactions between HA and other constituents of synovial fluid (SF). Frictional measurements between the AC surface and the glass were performed with simultaneous in situ observation of the contact zone by fluorescence microscopy. Using this methodology, a decrease in AC COF with an increase in the fluorescence intensity emitted from contact with HA was observed, while the phenomenon was found to be MW-dependent. These findings demonstrate that high-MW HA is more effective within a resumption of healthy AC lubrication due to a better adhesion to the AC surface.

Tribological behaviour of 3D printed materials for small joint implants: A pilot study

Additive manufacturing is a progressive method in endoprosthetics enabling customisation of implants. However, the challenge is to design articulating surfaces that are wear resistant in a long term. To tackle this challenge, it is necessary to understand the interaction between the surfaces and the lubricant synovial fluid as well as the mechanism of lubrication film formation. In this study we observed three synovial fluid constituents (albumin, γ-globulin a hyaluronic acid) in the contact area simultaneously with the coefficient of friction (CoF). Two metal alloys, CoCrMo and Ti6Al4V covered by DLC, were selected for the experiments as they are both suitable for the additive technology and commonly used in implants manufacturing. The tests were running on a custom-made pin-on-plate tribometer equipped for optical fluorescence measurements. The test apparatus allowed reciprocating motion and observation of the contact area. Our results showed differences in the pace of the CoF increase between the alloys and differences between the samples manufactured by the conventional and the additive manufacturing method. Both the conventionally and additively manufactured CrCrMo samples showed a stable CoF values from the beginning of the experiments: 0.66 (SD 0.02) for the conventional manufacturing CrCrMo samples and 0.53 (SD 0.01) for the additive manufacturing CrCrMo samples. The Ti6Al4V/DLC samples showed a stable CoF values similar to those of the CoCrMo samples not until the 240 s of experiment. These results are related to the protein formation in the contact areas as suggested by a similar increasing trend of the individual synovial fluid constituents in the contact. Increasing protein amounts in the contact led to CoF increase. There were also differences in the ratios of the individual constituents, where both the CoCrMo and the Ti6Al4V/ DLC samples manufactured additionally showed lower concentrations of γ-globulin and hyaluronic acid. These pilot results, on the one hand, support the potential of the additive manufacturing in the implantology and, on the other hand, demonstrate the application of a method suitable for the analysis of the lubricant behaviour in the contact. The method is limited in using the intensity of the emitted light to observe the behaviour of the lubricant film. Future development of the method will require a direct quantification of film thickness.

The role of synovial fluid constituents in the lubrication of collagen-glycosaminoglycan scaffolds for cartilage repair

Extracellular matrix (ECM)-derived scaffolds have shown promise as tissue-engineered grafts for promoting cartilage repair. However, there has been a lack of focus on fine-tuning the frictional properties of scaffolds for cartilage tissue engineering as well as understanding their interactions with synovial fluid constituents. Proteoglycan-4 (PRG4) and hyaluronan (HA) are macromolecules within synovial fluid that play key roles as boundary mode lubricants during cartilage surface interactions. The overall objective of this study was to characterize the role PRG4 and HA play in the lubricating function of collagen-glycosaminoglycan (GAG) scaffolds for cartilage repair. As a first step towards this goal, we aimed to develop a suitable in vitro friction test to establish the boundary mode lubrication parameters for collagen-GAG scaffolds articulated against glass in a phosphate buffered saline (PBS) bath. Subsequently, we sought to leverage this system to determine the effect of physiological synovial fluid lubricants, PRG4 and HA, on the frictional properties of collagen-GAG scaffolds, with scaffolds hydrated in PBS and bovine synovial fluid (bSF) serving as negative and positive controls, respectively. At all compressive strains examined (ε = 0.1–0.5), fluid depressurization within hydrated collagen-GAG scaffolds was >99% complete at ½ minute. The coefficient of friction was stable at all compressive strains (ranging from a low 0.103 ± 0.010 at ε = 0.3 up to 0.121 ± 0.015 at ε = 0.4) and indicative of boundary-mode conditions. Immunohistochemistry demonstrated that PRG4 from recombinant human (rh) and bovine sources adsorbed to collagen-GAG scaffolds and the coefficient of friction for scaffolds immersed in rhPRG4 (0.067 ± 0.027) and normal bSF (0.056 ± 0.020) solution decreased compared to PBS (0.118 ± 0.21, both p < 0.05, at ε = 0.2). The ability of the adsorbed rhPRG4 to reduce friction on the scaffolds indicates that its incorporation within collagen-GAG biomaterials may enhance their lubricating ability as potential tissue-engineered cartilage replacements. To conclude, this study reports the development of an in vitro friction test capable of characterizing the coefficient of friction of ECM-derived scaffolds tested in a range of synovial fluid lubricants and demonstrates frictional properties as a potential design parameter for implants and materials for soft tissue replacement.

Effects of Synovial Fluid Constituents on Friction between UHMWPE and CoCrMo

Effects of Synovial Fluid Constituents on Friction between UHMWPE and CoCrMo

Releasable agarose-hyaluronan hydrogel with anti-friction performance and enhanced stability for artificial joint applications

Hyaluronic acid (HA) as a major constituent of bionic synovial fluid (BSF) has significant role in lubrication of human body hip joint. Those who mostly suffer from joint related disease prefer to try injections of synovia over of total hip replacement (THR). However, affection of the metabolism process to the injected synovia is able to decrease the life time of the prostheses. In this study, injectable and thermosensitive agarose hydrogel as a carrier for hyaluronic acid has been investigated to extend the life time of the artificial hip joints. Experimental evidences reveal bioactivity, superior viscoelasticity and naturally amorphous network structure of the HA. This material in combination with the large molecules of agarose is able to create three-dimensional polymeric network for separating the conterminous surfaces of bearings and improve the lubrication with more than 30 % reduction rate for coefficient of the friction. Role of mechanical and rheological properties of designed polymeric network in cumulative sustained released of lubricants has been widely investigated. Novelty of the present work provides a survey to the long-term lubrication of artificial hip joints.

Effect of Lubricin Mimetics on the Inhibition of Osteoarthritis in a Rat Anterior Cruciate Ligament Transection Model

Background: Lubricin, a mucinous glycoprotein, plays a chondroprotective role as a constituent of synovial fluid. Structural analogs have been synthesized to mimic the structure and function of native lubricin in an effort to recapitulate this effect with the goal of delaying progression of osteoarthritis (OA). Purpose: To investigate the efficacy of intra-articular injections of lubricin mimetics in slowing or preventing the progression of posttraumatic OA by using a rat anterior cruciate ligament transection model. Study Design: Controlled laboratory design. Methods: Four lubricin mimetics were investigated, differing from one another in their binding orientations and steric interactions. Eighty skeletally mature Sprague-Dawley rats underwent bilateral anterior cruciate ligament transections and were randomly allocated to receive intra-articular injections (50 µL/injection) of 1 of the 4 mimetics in the right knee and equal volumes of saline injection in the contralateral knee (control). All rats were euthanized 8 weeks postoperatively and assessed via biomechanical analysis, which evaluated comparative friction coefficients across the 4 groups, and histological evaluation of articular cartilage, osteophytes, and synovitis. The Osteoarthritis Research Society International (OARSI) histopathological assessment system was used to evaluate the degree of articular cartilage degeneration and osteophytes, while synovitis was assessed through a semiquantitative scoring system. Binding efficacy of the 4 mimetics was assessed in vitro and in vivo through the immunohistochemical localization of polyethylene glycol. Articular cartilage degeneration and synovitis scoring data analyses were performed with generalized estimating equation modeling. Results: Injection of the group 3 mimetic (random 24 + 400 + 30) directly correlated with improved OARSI scores for femoral articular cartilage degeneration when compared with saline-injected contralateral control knees (P = .0410). No lubricin mimetic group demonstrated statistically significant differences in OARSI scores for tibial articular cartilage degeneration. Injection of the group 4 mimetic (AB 24 + 400 + 30) led to a statistically significant difference in osteophyte OARSI score (P = .0019). None of the 4 lubricin mimetics injections incited an additive synovial inflammatory response. Immunohistochemical staining substantiated the binding capacity of all 4 mimetics, while in vivo experimentation revealed that the group 1 and 3 mimetics were still retained within the joint 4 weeks after injection. There were no differences in friction coefficients between any pair of groups and no significant trends based on lubricin mimetic structure. Conclusion: We demonstrated that the tribosupplementation of a traumatically injured knee with a specific lubricin structural analog may attenuate the natural progression of OA. Clinical Relevance: The current lack of efficacious clinical options to counter the onset and subsequent development of OA suggests that further investigation into the synthesis and behavior of lubricin analogs could yield novel translational applications.

Сравнительный анализ биохимического состава синовиальной жидкости у больных с инфекционными осложнениями после эндопротезирования коленного сустава

Introduction Biochemical parameters of synovial fluid constituents were reviewed in patients prior to total knee replacement (TKR). The diagnostic value of certain biochemical tests was identified as prognostic factors in the development of infection. Purpose Comparative biochemical analysis was performed for pathogenic microflora free synovial fluid of patients grouped according to characteristics of infectious complications prior to TKR. Material and methods Synovial fluid samples with isolated strains of Staphylососcus aureus, Klеbsiella sp. and aerobic gram-positive bacilli were excluded from the study. Total protein and its fractions, electrolytes, lipid peroxidation and catalase levels were measured in the synovial fluid. Electrolytes, lipid peroxidation and catalase were determined in the synovial fluid with exclusion of samples with identified aerobic gram-positive bacilli in bacterial culture. Results Preoperative assessment of synovial fluid showed changes in cholesterol concentration and systemic electrolyte index in TKR patients later grouped into periprosthetic infection and non-infection cases. No changes were seen in protein panel. Levels of total protein and albumin were elevated in both groups. Conclusion Our findings suggest that biochemical parameters of synovial fluid can serve as a prognostic tool for infection following TKR.

On the observation of lubrication mechanisms within hip joint replacements. Part I: Hard-on-soft bearing pairs

The present study describes the lubrication mechanisms within artificial hip joints considering real conformity of rubbing surfaces. Part I is focused on hard-on-soft material combination, introducing the fundamentals of lubrication performance. These pairs have not been explored in terms of in situ observation before. The contact of metal femoral component articulating with transparent polymer acetabular cup was studied using a hip joint simulator. The film formation was evaluated by fluorescent microscopy method. Various model synovial fluids were employed while the key constituents, i.e. albumin, γ-globulin, and hyaluronic acid were fluorescently stained to determine its role in film formation process. Two types of the tests were performed. The first dynamic test aimed on the development of film thickness under constant load during motor driven swinging motion mimicking flexion-extension. Subsequently, a combined test was designed consisting of the three phases; static part with loading/unloading phase (1), pendulum swinging till spontaneous damping of the motion due to friction (2), and static observation under the constant load (3). The results clearly confirmed that the interaction of constituents of synovial fluid plays a dominant role and substantially influences the lubrication conditions. In particular, the main finding coming from the present study is that γ-globulin together with hyaluronic acid form relatively thin stable boundary layer enabling the enhanced adsorption of albumin, thus increasing the lubricant film. Part II of the present study is focused on hard-on-hard pairs while the main differences in film formation process are highlighted among others.

AN OVERVIEW OF VISCOSUPPLEMENTS: THERAPEUTIC MODALITY FOR THE AILMENT OF OSTEOARTHRITIS

Osteoarthritis is a multifarious joint disease and is caused by inflammatory mediators, along with a procedure of wear and tear of cartilage. Osteoarthritis outcome in cartilage degradation, synovial inflammation, subchondral bone eburnation, degeneration of menisci, and capsular hypertrophy, which takes part in the pathogenesis of Osteoarthritis. Pain is the leading symptom of Osteoarthritis. However the precise mechanism causing pain is multifactorial and is still not well known. Viscosupplementation with intraarticular hylauronic acid promotes chondrocyte hyaluronic acid synthesis and prevents the additional cartilage degradation and may possible help to promote the cartilage regeneration. It is also postulated to diminish the production of inflammatory mediators and matrix metalloproteinase involved in Osteoarthritis. Viscosupplementation decline osteoarthritis symptoms in early to judicious Osteoarthritis, and improves functional outcome, if other conservative treatment modalities are ineffective. Hyaluronic acid (HA) is the major constituent of a 1-­‐2μm layer on the surface of articular cartilage; it is also a major constituent of synovial fluid. HA has many properties including exerting an anti-inflammatory effect, it acts as a lubricant when movements in the joint are slow and as a shock absorber when movements are fast effect. Viscosupplementation relieves the symptoms of osteoarthritis of the knee, and this therapeutic effect may last several weeks. However, it is apparently not much greater than that of placebo and, according to some studies, it barely reaches clinical significance. Its pain-relieving effect seems comparable to that of other non-surgical options. The modest clinical benefit of viscosupplementation may never be great enough to outweigh its disadvantages, which include slow onset of action, the need for several weekly injections, the low but present risk of adverse reactions and the relatively high cost of this treatment. It helps in improving the function in early osteoarthritis knee joint and might delay the need for future knee surgery Keywords: Joint disorders, intraarticular hylauronic acid, non-steroidal anti-inflammatory drugs, osteoarthritisÂ

Contribution of synovial lining cells to synovial vascularization of the rat temporomandibular joint.

The lining layer of the synovial membrane in the temporomandibular joint (TMJ) contains two types of lining cells: macrophage-like type A and fibroblast-like type B cells. The type B cells are particularly heterogeneous in their morphology and immunoreactivity, so that details of their functions remain unclear. Some of the type B cells exhibit certain resemblances in their ultrastructure to those of an activated capillary pericyte at the initial stage of the angiogenesis. The articular surface, composed of cartilage and the disc in the TMJ, has few vasculatures, whereas the synovial lining layer is richly equipped with blood capillaries to produce the constituent of synovial fluid. The present study investigated at both the light and electron microscopic levels the immunocytochemical characteristics of the synovial lining cells in the adult rat TMJ, focusing on their contribution to the synovial vascularization. It also employed an intravascular perfusion with Lycopersicon esculentum (tomato) lectin to identify functional vessels invivo. Results showed that several type B cells expressed desmin, a muscle-specific intermediate filament which is known as the earliest protein to appear during myogenesis as well as being a marker for the immature capillary pericyte. These desmin-positive type B cells showed immunoreactions for vimentin and pericyte markers (neuron-glial 2; NG2 and PDGFRβ) but not for the other markers of myogenic cells (MyoD and myogenin) or a contractile apparatus (αSMA and caldesmon). Immunoreactivity for RECA-1, an endothelial marker, was observed in the macrophage-like type A cells. The arterioles and venules inside the synovial folds extended numerous capillaries with RECA-1-positive endothelial cells and desmin-positive pericytes to distribute densely in the lining layer. The distal portion of these capillaries showing RECA-1-immunoreactivity lacked lectin-staining, indicating a loss of blood-circulation due to sprouting or termination in the lining layer. The desmin-positive type B and RECA-1-positive type A cells attached to this portion of the capillaries. Some capillaries in the lining layer also expressed ninein, a marker for sprouting endothelial cells, called tip cells. Since an activated pericyte, macrophage and tip cell are known to act together at the forefront of the vessel sprout during angiogenesis, the desmin-positive type B cell and RECA-1-positive type A cell might serve as these angiogenic cells in the synovial lining layer. Tomato lectin perfusion following decalcification would be a highly useful tool for research on the vasculature of the mineralized tissue. Use of this technique combined with immunohistochemistry should permit future extensive investigations on the presence of the physiological angiogenesis and on the function of the lining cells in the synovial membrane.

Cartilage boundary lubrication synergism is mediated by hyaluronan concentration and PRG4 concentration and structure

BackgroundProteoglycan 4 (PRG4) and hyaluronan (HA) are key synovial fluid constituents that contribute synergistically to cartilage boundary lubrication; however, the effects of their concentrations as well as their structure, both of which can be altered in osteoarthritis, on this functional synergism are unknown. The objectives of this study were to evaluate cartilage boundary lubricating ability of 1) PRG4 + HA in solution at constant HA concentration in a range of PRG4 concentrations, 2) constant PRG4 concentration in a range of HA concentrations, 3) HA + reduced/alkylated (R/A) PRG4, and 4) hylan G-F 20 + PRG4.MethodsStatic and kinetic friction coefficients (μstatic,Neq, <μkinetic,Neq>) were measured using a previously characterized cartilage-cartilage boundary mode friction test for the following concentrations of purified PRG4 and HA: Test 1: HA (1.5 MDa, 3.3 mg/mL) + PRG4 from 4.5 – 1500 μg/mL; Test 2: PRG4 (450, 150, 45 μg/mL) + HA (1.5 MDa) from 0.3 – 3.3 mg/mL. Test 3: hylan G-F 20 (3. 3 mg/mL) + PRG4 (450 μg/mL). Test 4: HA (3.3 mg/mL) + R/A PRG4 (450 μg/mL). ANOVA was used to compare lubricants within (comparing 6 lubricants of interest) and between (comparing 3 lubricants of interest) test sequences, with Tukey and Fishers post-hoc testing respectively.ResultsThis study demonstrates that both PRG4 and HA concentration, as well as PRG4 disulfide-bonded structure, can alter the cartilage boundary lubricating ability of PRG4 + HA solutions. The boundary lubricating ability of high MW HA + PRG4 solutions was limited by very low concentrations of PRG4. Decreased concentrations of high MW HA also limited the cartilage boundary lubricating ability of HA + PRG4 solutions, with the effect exacerbated by low PRG4 concentrations. The reduction of friction by addition of PRG4 to a cross-linked HA viscosupplement product, but not with addition of R/A PRG4 to HA, is consistent with a non-covalent mechanism of interaction where tertiary and quaternary PRG4 structure are important.ConclusionsCollectively, these results demonstrate that deficiency of either or both PRG4 and HA, or alterations in PRG4 structure, may be detrimental to SF cartilage boundary lubricating function. This study provides further insight into the nature of cartilage boundary lubrication and advancement towards potential formulation of new intra-articular biotherapeutic treatments for osteoarthritis using PRG4 ± HA.

Elastoviscous Transitions of Articular Cartilage Reveal a Mechanism of Synergy between Lubricin and Hyaluronic Acid.

When lubricated by synovial fluid, articular cartilage provides some of the lowest friction coefficients found in nature. While it is known that macromolecular constituents of synovial fluid provide it with its lubricating ability, it is not fully understood how two of the main molecules, lubricin and hyaluronic acid, lubricate and interact with one another. Here, we develop a novel framework for cartilage lubrication based on the elastoviscous transition to show that lubricin and hyaluronic acid lubricate by distinct mechanisms. Such analysis revealed nonspecific interactions between these molecules in which lubricin acts to concentrate hyaluronic acid near the tissue surface and promotes a transition to a low friction regime consistent with the theory of viscous boundary lubrication. Understanding the mechanics of synovial fluid not only provides insight into the progression of diseases such as arthritis, but also may be applicable to the development of new biomimetic lubricants.

Synthesis and characterization of a lubricin mimic (mLub) to reduce friction and adhesion on the articular cartilage surface

The lubricating proteoglycan, lubricin, facilitates the remarkable low friction and wear properties of articular cartilage in the synovial joints of the body. Lubricin lines the joint surfaces and plays a protective role as a boundary lubricant in sliding contact; decreased expression of lubricin is associated with cartilage degradation and the pathogenesis of osteoarthritis. An unmet need for early osteoarthritis treatment is the development of therapeutic molecules that mimic lubricin function and yet are also resistant to enzymatic degradation common in the damaged joint. Here, we engineered a lubricin mimic (mLub) that is less susceptible to enzymatic degradation and binds to the articular surface to reduce friction. mLub was synthesized using a chondroitin sulfate backbone with type II collagen and hyaluronic acid (HA) binding peptides to promote interaction with the articular surface and synovial fluid constituents. In vitro and in vivo characterization confirmed the binding ability of mLub to isolated type II collagen and HA, and to the cartilage surface. Following trypsin treatment to the cartilage surface, application of mLub, in combination with purified or commercially available hyaluronan, reduced the coefficient of friction, and adhesion, to control levels as assessed over macro-to micro-scales by rheometry and atomic force microscopy. In vivo studies demonstrate an mLub residency time of less than 1 week. Enhanced lubrication by mLub reduces surface friction and adhesion, which may suppress the progression of degradation and cartilage loss in the joint. mLub therefore shows potential for treatment in early osteoarthritis following injury.

Anti-lubricin monoclonal antibodies created using lubricin-knockout mice immunodetect lubricin in several species and in patients with healthy and diseased joints.

Lubricin, encoded by the gene PRG4, is the principal lubricant in articulating joints. We immunized mice genetically deficient for lubricin (Prg4-/-) with purified human lubricin, and generated several mAbs. We determined each mAb’s binding epitope, sensitivity, and specificity using biologic samples and recombinant lubricin sub-domains, and we also developed a competition ELISA assay to measure lubricin in synovial fluid and blood. We found the mAbs all recognized epitopes containing O-linked oligosaccharides conjugated to the peptide motif KEPAPTTT. By western blot, the mAbs detected lubricin in 1 μl of synovial fluid from several animal species, including human. The mAbs were specific for lubricin since they did not cross-react with other synovial fluid constituents from patients with camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP), who genetically lack this protein. The competition ELISA detected lubricin in blood samples from healthy individuals but not from patients with CACP, indicating blood can be used in a diagnostic test for patients suspected of having CACP. Lubricin epitopes in blood do not represent degradation fragments from synovial fluid. Therefore, although blood lubricin levels did not differentiate patients with inflammatory joint disease from healthy controls, epitope-specific anti-lubricin mAbs could be useful for monitoring disease activity in synovial fluid.

A chondrocyte infiltrated collagen type I/III membrane (MACI® implant) improves cartilage healing in the equine patellofemoral joint model

Autologous chondrocyte implantation (ACI) has improved outcome in long-term studies of joint repair in man. However, ACI requires sutured periosteal flaps to secure the cells, which precludes minimally-invasive implantation, and introduces complications with arthrofibrosis and graft hypertrophy. This study evaluated ACI on a collagen type I/III scaffold (matrix-induced autologous chondrocyte implantation; MACI(®)) in critical sized defects in the equine model. Chondrocytes were isolated from horses, expanded and seeded onto a collagen I/III membrane (ACI-Maix™) and implanted into one of two 15-mm defects in the femoral trochlear ridge of six horses. Control defects remained empty as ungrafted debrided defects. The animals were examined daily, scored by second look arthroscopy at 12 weeks, and necropsy examination 6 months after implantation. Reaction to the implant was determined by lameness, and synovial fluid constituents and synovial membrane histology. Cartilage healing was assessed by arthroscopic scores, gross assessment, repair tissue histology and immunohistochemistry, cartilage glycosaminoglycan (GAG) and DNA assay, and mechanical testing. MACI(®) implanted defects had improved arthroscopic second-look, gross healing, and composite histologic scores, compared to spontaneously healing empty defects. Cartilage GAG and DNA content in the defects repaired by MACI implant were significantly improved compared to controls. Mechanical properties were improved but remained inferior to normal cartilage. There was minimal evidence of reaction to the implant in the synovial fluid, synovial membrane, subchondral bone, or cartilage. The MACI(®) implant appeared to improve cartilage healing in a critical sized defect in the equine model evaluated over 6 months.

Mechanism of Boundary Lubrication by Synovial Fluid Constituents for Reduction of Friction and Wear of Artificial Articular Cartilage

Mechanism of Boundary Lubrication by Synovial Fluid Constituents for Reduction of Friction and Wear of Artificial Articular Cartilage

Erratum to: Influence of synovia constituents on tribological behaviors of articular cartilage

Teruo MURAKAMI, Seido YARIMITSU, Kazuhiro NAKASHIMA, Yoshinori SAWAE, Nobuo SAKAI 1 Research Center for Advanced Biomechanics, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan Department of Mechanical Engineering, Faculty of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan 3 Department of Applied Science for Integrated System Engineering, Graduate School of Engineering, Kyushu Institute of Technology, 1-1, Sensuicho, Tobata-ku, Kitakyushu, 804-8550, Japan Received: 31 December 2012 / Revised: 18 February 2013 / Accepted: 16 March 2013 © The author(s) 2014. This article is published with open access at Springerlink.com

Role of Synovial Fluid Constituents on Tribological Behavior of Synovial Joints - Application for Developing Novel Therapeutic Substitutes

Joint diseases represent a major health problem because they evolve towards the wear of cartilage for which no treatment is really effective. The difficulties in identifying the causes of these diseases are related to the biochemical and structural complexity of synovial fluid that allow cartilage lubrication. Thereby, recent studies show that synovial fluid contains micro-vesicles filled with a glycoprotein gel (hyaluronic acid and protein) surrounded by stacks of lipid bilayers which gives it excellent lubricating properties [1]. On the other side, this stable structure in vivo, becomes unstable in the ex vivo conditions. In this context, the study aims to tests the lubricating properties of synovial fluid constituents in order to identify their role on the tribological behavior of synovial joints and to develop a biomimetic synovial fluid using self-assembly of polyelectrolytes in order to stabilize the ex vivo structure for the potential therapeutic synovial fluid substitutes.Our results show that the new synthetized polysaccharides influence the friction coefficient, the stability and the wear of lipids bilayers, providing lubricating properties superior to synovial fluid biological constituents. In addition, their capacity to be structured in micro-spheres and included in lipid micro-vesicles indicates them as good biomimetic lubricants. This will allow a longer stability of synovial fluid substitutes in ex-vivo conditions in order to achieve the best lubricating properties and to improve the joint diseases treatment.

Boundary cartilage lubrication: review of current concepts

Effective lubrication of synovial joints is important to prevent cartilage degeneration and to keep the joints healthy. This paper sets out the basics of engineering lubrication with respect to the composition and properties of synovial fluid constituents. Two basic types of boundary lubrication are discussed: the presence of highly hydrophilic proteoglycans that provide a water liquid film, and the existence of multilamellar phospholipids lubricating layers at the surface ofarticular cartilage. Based on current knowledge, we may conclude that no single mechanism of boundary lubrication exists, and that effective boundary lubrication of synovial joints is maintained by the synergic effect of all synovial fluid constituents.