ObjectiveBased on our recent study, which showed that cartilage fatigue failure in reciprocating sliding contact results from cyclical compressive forces, not from cyclical frictional forces, we hypothesize that a major functional role for synovial fluid (SF) is to reduce the rate of articular cartilage fatigue failure from cyclical compressive loading. DesignThe rate of cartilage fatigue failure due to repetitive compressive loading was measured by sliding a glass lens against an immature bovine cartilage tibial plateau strip immersed in mature bovine SF, phosphate-buffered saline (PBS), or SF/PBS dilutions (50% SF and 25% SF; n=8 for all four bath conditions). After 24 hours of reciprocating sliding (5,400 cycles), samples were visually assessed and if damage was observed, the test was terminated; otherwise, testing was continued for 72 hours (16,200 cycles), with solution refreshed daily. ResultsAll eight samples in the PBS group exhibited physical damage after 24 hours, with an average final surface roughness of Rq=0.210±0.067 mm. The SF group showed no damage after 24 hours; however, two of eight samples became damaged after 72 hours, producing a significantly lower average surface roughness than the PBS group (Rq=0.059±0.030 mm; p<10−4). For the remaining groups, at 72 hours one of eight samples damaged in the 50% SF group, and five of eight samples damaged in the 25% SF group. ConclusionsThe results strongly support our hypothesis, showing that decreased amounts of SF in the testing bath produces increased rates of fatigue failure in cartilage that was subjected to reciprocating sliding contact.