Compressive stress relaxation behavior of articular cartilage and its effects on fluid pressure and solid displacement due to non-Newtonian flow

In this study, we investigate the effects of the power-law index and permeability parameter on the deformation of soft tissue (articular cartilage) which is bathed in the non-Newtonian fluid under stress-relaxation in compression. Ramp displacement is imposed on the surface of hydrated soft tissue. Deformation of the tissue and the fluid pressure is examined for the fast and slow rate of compression. We have employed a linear biphasic mixture theory to develop a mathematical model for compressive stress-relaxation behavior of articular cartilage for non-Newtonian flow. Numerical results indicate that shear-thinning fluids induce less solid deformation and exhibit more fluid pressure as compared to shear-thickening fluids for fast and slow rate of compression. The results also show that linear permeability induces more deformation as compared to strain-dependent nonlinear permeability due to viscoelastic nature of articular cartilage.

Enhanced Tribocorrosion Resistance of Hard Ceramic Coated Ti-6Al-4V Alloy for Hip Implant Application: In-Vitro Simulation Study

Developing coatings for various applications is an area of research of uttermost importance, to protect surfaces from severe damage by improving the wear and corrosion resistance of the materials. Recently, there has been increasing interest in ceramic coatings for biomedical applications, as the surface may become more inert in nature for the biological reactions and potentially increase the lifespan of the implants and minimize the side effects on the patients. Hence this study is focused on the tribocorrosion behavior of the ceramic coatings for the hip implant application on commonly used implant titanium alloy. The three types of the ceramic coatings are conventional monolithic micron alumina (IDA), micron alumina-40 wt % yttria-stabilized zirconia (YSZ) composite coating (IDAZ), and by-layer nanostructured alumina-13 wt % titania/YSZ (IDZAT) on Ti-6Al-4V alloy. A series of tests, under free potential and potentiostatic mode, were conducted using a hip simulator tribocorrosion setup under simulated joint fluid (bovine calf serum with protein concentration 30g/L). The tribological conditions are pin-on-ball contact with a load of 16N (approximately contact pressure of 50 MPa), the frequency of 1 Hz (walking frequency), and with an amplitude of 30°. The tribocorrosion studies clearly revealed that the coatings have better wear and corrosion resistance and the predominant damage mechanism was mechanical wear rather than corrosion. Among the coatings, the IDZAT shows enhanced tribocorrosion performance by exhibiting more positive OCP, no induced current, and a lower coefficient of friction.

Effect of counterface on cartilage boundary lubricating ability by proteoglycan 4 and hyaluronan: Cartilage-glass versus cartilage-cartilage

The objective of this study was to determine the effect of different sliding interface materials (counterface) on the cartilage lubricating ability of proteoglycan 4 (PRG4) and hyaluronan (HA) by measuring the kinetic coefficient of friction on cartilage-glass and cartilage-cartilage interfaces over a wide range of sliding velocities. The lubrication properties of PRG4 and HA were assessed at cartilage-glass and cartilage-cartilage interfaces using a previously described test setup with a stationary area of contact. Samples were articulated at varying effective sliding velocities of 10, 3, 1, 0.3, 0.1, and 0.01 mm/s. The response of PRG4 and HA as effective friction-reducing cartilage boundary lubricants was varied and was dependent primarily on the test counterface. At a physiological cartilage-cartilage interface both HA and PRG4 effectively reduced friction compared to PBS at slower speeds while at higher speeds PRG4 was similar to PBS, and HA similar to SF. Conversely, at a cartilage-glass interface HA demonstrated no friction reducing ability compared to PBS, and PRG4 appeared just as effective as SF. Cartilage-glass friction coefficients were also significantly greater than cartilage-cartilage friction coefficients. These results indicate the in vitro friction coefficient of putative cartilage boundary lubricants can be affected by the test counterface and suggest that use of synthetic surfaces in studying cartilage boundary lubrication may not always be appropriate for all molecules of interest. As such, care should be taken when interpreting such data, specifically when comparing to in vitro data obtained at a cartilage-cartilage interface, and especially when extrapolating to in vivo situations. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2923-2931, 2018.

Reduction of friction by recombinant human proteoglycan 4 in IL-1α stimulated bovine cartilage explants

A boundary lubricant attaches and protects sliding bearing surfaces by preventing interlocking asperity-asperity contact. Proteoglycan-4 (PRG4) is a boundary lubricant found in the synovial fluid that provides chondroprotection to articular surfaces. Inflammation of the diarthrodial joint modulates local PRG4 concentration. Thus, we measured the effects of inflammation, with Interleukin-1α (IL-1α) incubation, upon boundary lubrication and PRG4 expression in bovine cartilage explants. We further aimed to determine whether the addition of exogenous human recombinant PRG4 (rhPRG4) could mitigate the effects of inflammation on boundary lubrication and PRG4 expression in vitro. Cartilage explants, following a 7 day incubation with IL-1α, were tested in a disc-on-disc configuration using either rhPRG4 or saline (PBS control) as a lubricant. Following mechanical testing, explants were studied immunohistochemically or underwent RNA extraction for real-time polymerase chain reaction (RT-PCR). We found that static coefficient of friction (COF) significantly decreased to 0.14 ± 0.065 from 0.21 ± 0.059 (p = 0.014) in IL-1α stimulated explants lubricated with rhPRG4, as compared to PBS. PRG4 expression was significantly up regulated from 30.8 ± 19 copies in control explants lubricated with PBS to 3330 ± 1760 copies in control explants lubricated with rhPRG4 (p < 0.001). Explants stimulated with IL-1α displayed no increase in PRG4 expression upon lubrication with rhPRG4, but with PBS as the lubricant, IL-1α stimulation significantly increased PRG4 expression compared to the control condition from 30.8 ± 19 copies to 401 ± 340 copies (p = 0.015). Overall, these data suggest that exogenous rhPRG4 may provide a therapeutic option for reducing friction in transient inflammatory conditions and increasing PRG4 expression. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:580-589, 2017.

Transient Elastohydrodynamic Lubrication Models for the Human Ankle Joint

An equivalent bearing was proposed to represent the normal human ankle joint. The geometry was based on measurements of dissected ankle joints and tissue properties were obtained from the work of previous investigators. Theoretical models were developed to estimate the cyclic variation in lubricant film thickness and coefficient of friction during repetitive activities such as walking. Solutions were obtained for various combinations of input parameters. For the conditions representing the walking cycle, film thicknesses of about 0.7 μm were calculated. Although this value was smaller than most previous measurements of the rms roughness of cartilage, it was not much smaller and suggested that transient elastohydrodynamic lubrication played a role in synovial joint lubrication. The possibility of full fluid film lubrication was supported only when a very high input viscosity was employed, based on values estimated from the previous experimental studies of the boosted lubrication mechanism. Also, an attempt was made to link the current findings to a published experimental study of whole joint lubrication.

Computational aspects in mechanical modeling of the articular cartilage tissue

This review focuses on the modeling of articular cartilage (at the tissue level), chondrocyte mechanobiology (at the cell level) and a combination of both in a multiscale computation scheme. The primary objective is to evaluate the advantages and disadvantages of conventional models implemented to study the mechanics of the articular cartilage tissue and chondrocytes. From monophasic material models as the simplest form to more complicated multiscale theories, these approaches have been frequently used to model articular cartilage and have contributed significantly to modeling joint mechanics, addressing and resolving numerous issues regarding cartilage mechanics and function. It should be noted that attentiveness is important when using different modeling approaches, as the choice of the model limits the applications available. In this review, we discuss the conventional models applicable to some of the mechanical aspects of articular cartilage such as lubrication, swelling pressure and chondrocyte mechanics and address some of the issues associated with the current modeling approaches. We then suggest future pathways for a more realistic modeling strategy as applied for the simulation of the mechanics of the cartilage tissue using multiscale and parallelized finite element method.

Shape, loading, and motion in the bioengineering design, fabrication, and testing of personalized synovial joints

With continued development and improvement of tissue engineering therapies for small articular lesions, increased attention is being focused on the challenge of engineering partial or whole synovial joints. Joint-scale constructs could have applications in the treatment of large areas of articular damage or in biological arthroplasty of severely degenerate joints. This review considers the roles of shape, loading and motion in synovial joint mechanobiology and their incorporation into the design, fabrication, and testing of engineered partial or whole joints. Incidence of degeneration, degree of impairment, and efficacy of current treatments are critical factors in choosing a target for joint bioengineering. The form and function of native joints may guide the design of engineered joint-scale constructs with respect to size, shape, and maturity. Fabrication challenges for joint-scale engineering include controlling chemo-mechano-biological microenvironments to promote the development and growth of multiple tissues with integrated interfaces or lubricated surfaces into anatomical shapes, and developing joint-scale bioreactors which nurture and stimulate the tissue with loading and motion. Finally, evaluation of load-bearing and tribological properties can range from tissue to joint scale and can focus on biological structure at present or after adaptation.

Association between friction and wear in diarthrodial joints lacking lubricin

Objective

The glycoprotein lubricin (encoded by the gene Prg4) is secreted by surface chondrocytes and synovial cells, and has been shown to reduce friction in vitro. In contrast to man-made bearings, mammalian diarthrodial joints must endogenously produce friction-reducing agents. This study was undertaken to investigate whether friction is associated with wear.

Methods

The lubricating ability of synovial fluid (SF) samples from humans with genetic lubricin deficiency was tested in vitro. The coefficient of friction in the knee joints of normal and lubricin-null mice was measured ex vivo; these joints were also studied by light and electron microscopy. Atomic force microscopy was used to image and measure how lubricin reduces friction in vitro.

Results

SF lacking lubricin failed to reduce friction in the boundary mode. Joints of lubricin-null mice showed early wear and higher friction than joints from their wild-type counterparts. Lubricin self-organized and reduced the work of adhesion between apposing asperities.

Conclusion

These data show that friction is coupled with wear at the cartilage surface in vivo. They imply that acquired lubricin degradation occurring in inflammatory joint diseases predisposes the cartilage to damage. Lastly, they suggest that lubricin, or similar biomolecules, will have applications in man-made devices in which reducing friction is essential.

Effect of synovial fluid on boundary lubrication of articular cartilage

OBJECTIVES

The lubrication of articulating cartilage surfaces in joints occurs through several distinct modes. In the boundary mode of lubrication, load is supported by surface-to-surface contact, a feature that makes this mode particularly important for maintenance of the normally pristine articular surface. A boundary mode of lubrication is indicated by a kinetic friction coefficient being invariant with factors that influence formation of a fluid film, including sliding velocity and axial load. The objectives of this study were to (1) implement and extend an in vitro articular cartilage-on-cartilage lubrication test to elucidate the dependence of the friction properties on sliding velocity, axial load, and time, and establish conditions where a boundary mode of lubrication is dominant, and (2) determine the effects of synovial fluid (SF) on boundary lubrication using this test.

METHODS

Fresh bovine osteochondral samples were analyzed in an annulus-on-disk rotational configuration, maintaining apposed articular surfaces in contact, to determine static (mu(static) and mu(static),(N(eq)) and kinetic ([mu(kinetic)] and [mu(kinetic),(N(eq))]) friction coefficients, each normalized to the instantaneous and equilibrium (N(eq)) normal loads, respectively.

RESULTS

With increasing pre-sliding durations, mu(static) and mu(static),(N(eq)) were similar, and increased up to 0.43 +/- 0.03 in phosphate buffered saline (PBS) and 0.19 +/- 0.01 in SF, whereas [mu(kinetic)] and [mu(kinetic),(N(eq))] were steady. Over a range of sliding velocities of 0.1-1 mm/s and compression levels of 18% and 24%, [mu(kinetic)] was 0.072 +/- 0.010 in PBS and 0.014 +/- 0.003 in SF, and [mu(kinetic),(N(eq))] was 0.093 +/- 0.005 in PBS and 0.018 +/- 0.002 in SF.

CONCLUSIONS

A boundary mode of lubrication was achieved in a cartilage-on-cartilage test configuration. SF functioned as an effective friction-lowering boundary lubricant for native articular cartilage surfaces.

Boundary lubrication of articular cartilage: Role of synovial fluid constituents

OBJECTIVE

To determine whether the synovial fluid (SF) constituents hyaluronan (HA), proteoglycan 4 (PRG4), and surface-active phospholipids (SAPL) contribute to boundary lubrication, either independently or additively, at an articular cartilage-cartilage interface.

METHODS

Cartilage boundary lubrication tests were performed with fresh bovine osteochondral samples. Tests were performed using graded concentrations of SF, HA, and PRG4 alone, a physiologic concentration of SAPL, and various combinations of HA, PRG4, and SAPL at physiologic concentrations. Static (mu(static, Neq)) and kinetic (<mu(kinetic, Neq)>) friction coefficients were calculated.

RESULTS

Normal SF functioned as an effective boundary lubricant both at a concentration of 100% (<mu(kinetic, Neq)> = 0.025) and at a 3-fold dilution (<mu(kinetic, Neq)> = 0.029). Both HA and PRG4 contributed independently to a low mu in a dose-dependent manner. Values of <mu(kinetic, Neq)> decreased from approximately 0.24 in phosphate buffered saline to 0.12 in 3,300 mug/ml HA and 0.11 in 450 mug/ml PRG4. HA and PRG4 in combination lowered mu further at the high concentrations, attaining a <mu(kinetic, Neq)> value of 0.066. SAPL at 200 mug/ml did not significantly lower mu, either independently or in combination with HA and PRG4.

CONCLUSION

The results described here indicate that SF constituents contribute, individually and in combination, both at physiologic and pathophysiologic concentrations, to the boundary lubrication of apposing articular cartilage surfaces. These results provide insight into the nature of the boundary lubrication of articular cartilage by SF and its constituents. They therefore provide insight regarding both the homeostatic maintenance of healthy joints and pathogenic processes in arthritic disease.

Reduced expression and proteolytic susceptibility of lubricin/superficial zone protein may explain early elevation in the coefficient of friction in the joints of rats with antigen-induced arthritis

OBJECTIVE

To investigate the effect of arthritis development and progression on the integrity and function of lubricin and the relationship of lubricin to cartilage damage in a rat antigen-induced arthritis model.

METHODS

Arthritis was induced in the right knee joints, using methylated bovine serum albumin and Freund's complete adjuvant. Whole joint friction measurements were performed ex vivo with a modified Stanton pendulum configuration, and coefficients of friction (mu) were determined. Levels of messenger RNA (mRNA) for lubricin, cathepsin B, and interleukin-1beta (IL-1beta) in synovial tissue from control and affected joints were determined by quantitative polymerase chain reaction. Lubricin staining in cartilage was performed using a lubricin-specific monoclonal antibody.

RESULTS

The mu values in excised right joints following arthritis induction were significantly (P < 0.001) higher than those in excised left joints. Lubricin mRNA expression levels in synovial tissue on days 4 and 7 after arthritis induction were significantly (P < 0.001) lower in the right joints compared with the left joints, whereas levels of cathepsin B and IL-1beta mRNA expression on days 4, 7, and 14 were significantly (P < 0.001) higher in the right joints than the left joints. Lubricin staining was diminished in cartilage from the right joints compared with the left joints.

CONCLUSION

Elevated coefficients of friction in arthritic joints occur concurrently with enhanced proteolytic degradation by up-regulated cathepsin B and other proteases, as well as decreased lubricin synthesis by synovial fibroblasts and superficial zone chondrocytes. Loss of joint lubrication is an early event in inflammatory arthropathy. Restoring chondroprotection and preventing potential wear-induced cartilage degradation may require lubricin supplementation in synovial fluid.

Static forces, structure and flow properties of complex fluids in highly confined geometries

The Surface Forces Apparatus has been successfully used to measure the static and dynamic forces between surfaces across ultra-thin films of water and aqueous electrolyte solutions, and--more recently--polyelectrolyte-coated and articular cartilage surfaces in various solutions including hyaluronan, lubricin, and synovial fluid. The results give new insights into the lubricating action of biological lubricants such as synovial fluid and hyaluronan (a polysaccharide in synovial fluid), and biological surfaces such as phospholipid bilayers and cartilage surfaces. Contrary to earlier indications of long-range water-structuring at biological surfaces, more recent measurements clearly show that the viscosity of physiologically concentrated water (saline) is bulk-like beyond the first 1 or 2 layers from a single surface, and beyond 4-6 layers in thin films between two surfaces (the structure and forces may, however, be affected to larger distances). This implies that most structural, interaction force, and viscosity-related phenomena are determined--not only by the properties of the solvent (water)per se--but also by the surfaces and the water, ions, solutes, and macromolecules (proteins, polymers) exposed or adsorbed at the surfaces and, to a lesser degree, dissolved in the solvent. However, sometimes it is difficult to make a clear differentiation, e.g., one could consider hydration or surface-bound 'structured' water as part of the surface or as part of the intervening water between the two surfaces.

Lubrication and wear properties of grafted polyelectrolytes, hyaluronan and hylan, measured in the surface forces apparatus

Hyaluronan is believed to have an important function in the boundary biolubrication of articular cartilage. Using a Surface Forces Apparatus, we tested the tribological properties of surface bound, rather than "free" hyaluronan. The grafting process of the polyelectrolyte included either a biological route via an HA-binding protein or a chemical reaction to covalently bind the polymer to a lipid bilayer coated surface. In another reaction, we constructed a surface with covalently grafted hylan (crosslinked hyaluronan). We studied the normal and shear forces between these surfaces. None of the systems demonstrated comparable lubrication to that found between cartilage surfaces except at very low loads. Both grafted hyaluronan and hylan generated coefficients of friction between 0.15 and 0.3. Thus, the polysaccharide, which is a constituent of the lamina splendens (outermost cartilage layer), is not expected to be the responsible molecule for the great lubricity of cartilage; however, it may contribute to the load bearing and wear protection of these surfaces. This was concluded from the results with hylan, where a thin gel layer was sufficient to shield the underlying surfaces from damage even at applied pressures of over 200 atmospheres during shear. Our study shows that a low coefficient of friction is not a requirement for, or necessarily a measure of, wear protection.

Association of articular cartilage degradation and loss of boundary-lubricating ability of synovial fluid following injury and inflammatory arthritis

OBJECTIVE

To study the relationship between the boundary-lubricating ability of synovial fluid (SF) and articular cartilage damage in a rabbit knee injury model, to correlate collagen markers of such damage with SF boundary-lubricating ability and elastase activity, and to examine the lubricating ability of SF, together with collagen markers of articular cartilage damage, under the inflammatory conditions of knee joint synovitis (KJS) and rheumatoid arthritis (RA).

METHODS

SF was aspirated weekly from the affected knee joints of 10 adult rabbits following transection of the anterior and posterior cruciate ligaments. The boundary-lubricating ability of SF was determined in vitro using a previously described friction apparatus. Lubricin concentrations and type II collagen (CII) peptides were quantified by sandwich enzyme-linked immunosorbent assays (ELISAs). Levels of the C-terminal neoepitope 9A4 (derived from collagenase degradation of CI, CII, and CIII) and of epitope 5-D-4 of keratan sulfate (a marker of proteoglycan depletion) were quantified by inhibition ELISAs. Elastase activity was measured spectrophotometrically. The sensitivity of purified human lubricin to digestion by neutrophil elastase (NE) was examined by Western blotting.

RESULTS

The lubricating ability of SF from injured rabbit knees was significantly decreased at weeks 2 and 3 compared with week 1 after injury. Lubricin concentrations were significantly higher at week 1 than at weeks 2 and 3. CII peptide concentrations increased significantly at weeks 2 and 3 compared with week 1, while 9A4 neoepitope concentrations increased significantly at week 3 compared with weeks 1 and 2. There were no significant differences in epitope 5-D-4 concentrations among the 3 weeks. Elastase activity in SF increased significantly at weeks 2 and 3 compared with week 1. Elastase activity correlated significantly with diminishing lubrication at weeks 1, 2, and 3. SF from patients with KJS or RA exhibited deficient lubrication and elevated levels of CII peptides compared with SF from normal controls. NE was shown to completely degrade purified human lubricin in vitro.

CONCLUSION

Loss of boundary-lubricating ability of SF after injury is associated with damage to the articular cartilage matrix. This can be attributed to inflammatory processes resulting from the injury, particularly in the early phases. This association also exists in patients with acute knee injuries or progressive chronic inflammatory arthritis.

Normal and prosthetic synovial joints are lubricated by surface-active phospholipid: a hypothesis

Much evidence supports the hypothesis that surface-active phospholipid (SAPL), which imparts the thin hydrophobic outermost lining to the normal articular surface, is the boundary lubricant reducing friction to remarkably low levels. We review this evidence and further hypothesize that SAPL produced in type B synoviocytes will also lubricate prostheses after implantation. This could explain why implanted hips display far less wear than hips in simulated wear trials do, even using protein as the lubricant whereas rougher surfaces can be tolerated in vivo. We introduce the concept that a deficiency of SAPL might explain the selective failure of prostheses just as osteoarthritic articular surfaces are deficient. This, in turn, leads to the replenishment of SAPL, as tested in OA, and the concept of prelubricating prostheses before implantation.

Homology of lubricin and superficial zone protein (SZP): products of megakaryocyte stimulating factor (MSF) gene expression by human synovial fibroblasts and articular chondrocytes localized to chromosome 1q25

We have previously identified megakaryocyte stimulating factor (MSF) gene expression by synovial fibroblasts as the origin of lubricin in the synovial cavity. Lubricin is a mucinous glycoprotein responsible for the boundary lubrication of articular cartilage. MSF has a significant homology to vitronectin and is composed of 12 exons. RNA was purified from human synovial fibroblasts and articular chondrocytes grown in vitro from tissue explants obtained from subjects without degenerative joint disease. RT-PCR was used with multiple complimentary primer pairs spanning the central mucin expressing exon 6 of the MSF gene and individual exons on both the N- and C-terminal sides of exon 6. Exons 2, 4 and 5 appear to be variably expressed by synovial fibroblasts and articular chondrocytes. Lubricating mucin, in the form of MSF, is expressed by both chondrocytes and synovial fibroblasts in vitro. Both lubricin and superficial zone protein (SZP), a related proteoglycan, share a similar primary structure but could differ in post-translational modifications with O-linked oligosaccharides which are predominant in lubricin and with limited amounts chondroitin and keratan sulfate found in SZP. Since most of the MSF exons are involved in the expression of lubricating mucin, a strong homology to vitronectin persists. It is therefore appropriate to consider that both SZP and lubricin occupy a new class of biomolecules termed tribonectins. Screening of a human genome bacterial artificial chromsome (BAC) library with a cDNA primer pair complimentary for exon 6 identified two clones. Both clones were complimentary for chromosome 1q25 by in situ hybridization. This same locus was previously implicated in camptodactyl-arthropathy-pericarditis syndrome (CAP) by genetic mapping. It is hypothesized that CAP, a large joint arthropathy, may be associated with ineffective boundary lubrication provided by synovial fluid.

Evaluation of the frictional properties of an elastomer with enhanced lipid-adsorbing ability

Wear particle production in load-bearing orthopaedic implants is one of the major factors currently limiting the service life of the implant. Most of the research carried out to date in attempting to solve this problem has used the approach of finding more wear-resistant biocompatible material pairs. In contrast, other researchers have attempted to reduce wear by encouraging elastohydrodynamic film formation through the use of elastomeric bearing surfaces. Unfortunately, these elastomeric bearing surfaces have poor tribological properties when a fluid film is not present. Boundary lubrication of an elastomeric orthopaedic bearing may alleviate some of these difficulties. The purpose of this research was to fabricate and characterize an elastomeric material that had a surface capable of specifically adsorbing a naturally occurring boundary lubricant. Dipalmitoyl phosphatidylcholine (DPPC) has been previously shown to be able to act as a boundary lubricant at stresses that occur in human load-bearing joints such as the hip and knee; therefore, DPPC was chosen for use in this study. It was expected that in an aqueous liposome suspension the static coefficient of friction microseconds of such a material would be lower, and increase less quickly over time, than a similar material without an ability to adsorb specifically DPPC when articulated against a polished chrome steel ball bearing. The lipid-adsorbing elastomer did not possess the desired tribological properties. This result was attributed to the polymer adsorbing the DPPC in the liposome phase and not in the bilayer phase, and interaction among the polymeric surface, DPPC and water. This approach to lubricating orthopaedic bearings was shown to have some merit, but a great deal of work needs to be done before such an approach can be used on a clinically available material.

Effect of phospholipidic boundary lubrication in rigid and compliant hemiarthroplasty models

Hemiarthroplasty may benefit from materials which produce lower friction and improved boundary lubrication protection during start-up conditions. The purpose of this study was to evaluate the effect of phospholipidic boundary lubrication in both rigid and compliant hemiarthroplasty. An in vitro model was designed to dissociate the relative contribution of implant material compliance and the presence of phospholipid to the overall friction of a hemiarthroplasty contact using bovine articular cartilage. Normal bovine articular cartilage was articulated against four flat materials using reciprocating motion: (a) borosilicate glass: (b) borosilicate glass coated with dipalmitoylphosphatidylcholine (DPPC); (c) polyurethane (PU) elastomer (Tecoflex SG93A, a medical-grade aliphatic thermoplastic PU, Thermedics Incorporated. Woburn, Massachusetts); and (d) surface-coated PU (Tecoflex SG93A substrate coated with lipid-attracting copolymer poly[methacryloyloxyethyl phosphorylcholine (MPC)-co-butyl methacrylate (BMA)]. Tests were conducted in physiologically simulated tribological conditions for a non-conformal point contact. Friction and lubrication analysis was performed using both static and kinetic coefficients of friction mu measured for each group as a function of time for a sliding distance of up to 60 m. Results showed that the inclusion of supplemental phospholipid, DPPC, on a rigid substrate significantly decreased mu in comparison with the control (cartilage-glass). Additionally, removal of phospholipid components from the articular cartilage surface produced a significantly greater start-up mu in comparison with normal cartilage at the test onset. The use of a material with a lower modulus resulted in lower mu for the entire duration of the test. Polyurethane elastomer coated with the lipid-attracting copolymer, poly(MPC-co-BMA), resulted in the lowest frictional response. As seen in this study, the improvement of low-modulus hemiarthroplasty may involve the optimization of chemical modification and incorporation of lipid-attracting MPC copolymers onto compliant materials. However, further tests are warranted to determine whether lipid-attracting MPC copolymers perform as well during long-time, in vivo wear studies.

Boundary lubrication in vivo

Evidence is reviewed for the concept that the body employs essentially the same lubrication system in many sites in the body where tissues slide over each other with such ease. This system consists of fluid adjacent to surfaces coated with an oligolamellar lining of surface-active phospholipid (SAPL) acting as a back-up boundary lubricant wherever the fluid film fails to support the load--a likely event at physiological velocities. Particular attention is paid to the load-bearing joints, where the issue of identifying the vital active ingredient in synovial fluid is reviewed, coming down--perhaps predictably--in favour of SAPL. It is also explained how Lubricin and hyaluronic acid (HA) could have 'carrier' functions for the highly insoluble SAPL, while HA has good wetting properties needed to promote hydrodynamic lubrication of a very hydrophobic articular surface by an aqueous fluid wherever the load permits. In addition to friction and wear, release is included as another major role of boundary lubricants, especially relevant in environments where proteins are found, many having adhesive properties. The discussion is extended to a mention of the lubrication of prosthetic implants and to disease states where a deficiency of boundary lubricant is implicated, particular attention being paid to osteoarthritis.

The influence of continuous sliding and subsequent surface wear on the friction of articular cartilage

Reciprocating motion friction tests were conducted upon cartilage-on-metal contacts while subjected to a constant load. Initial friction coefficients were compared with repeat friction coefficients following a sufficient load removal period. The repeat friction coefficients were marginally higher than the initial values and both were primarily dependent on the loading time. It was concluded that while a wear component had been identified, which modestly increased friction coefficients, the overriding parameter influencing friction was loading time. The authors postulate that fluid phase load carriage (being dependent on loading time) within the articular cartilage is largely responsible for low friction coefficients in the mixed and boundary lubrication regimes. This mechanism has been referred to as biphasic lubrication. Both synovial fluid and Ringer's solution were used as lubricants. Over the assessed 120 min loading time friction coefficients rose from 0.005 (for both lubricants) after 5 s to 0.50 and 0.57 for synovial fluid and Ringer's solution respectively. Synovial fluid was found to significantly reduce friction coefficients compared to Ringer's solution over broad ranges of the assessed loading times (p < 0.05). Stylus and non-contacting laser profilometry were successfully employed to provide reliable, quantitative and accurate measures of surface roughness. Laser profilometry before and after a continuous sliding friction test revealed a significant increase in surface roughness from Ra = 0.8 (+/- 0.2) micron to Ra = 2.1 (+/- 0.2) microns, (p < 0.0005); confirming that surface wear was occurring. Scanning electron microscopy (SEM) revealed the typical highly orientated collagen fibres of the superficial tangential zone. Environmental SEM (ESEM) of fully hydrated cartilage specimens provided largely featureless images of the surface which suggested that sample preparation for conventional SEM was detrimental to the authenticity of the cartilage surface appearance using SEM. Two distinct acellular, non-collagenous surface layers were identified using ESEM and transmission electron microscopy (TEM); respectively referred to as the boundary layer and surface lamina. The phospholipid/glycoprotein based boundary layer will provide boundary lubrication during intimate contact of opposing cartilage surfaces. The surface lamina, being a continuum of the proteoglycan interfibrillar matrix, is present to prevent fibrillation of the underlying collagen fibres. Both layers may contribute to the time dependent frictional response of articular cartilage. Although laser profilometry did reveal surface wear which was consistent with a small increase in friction, the primary variable controlling the friction coefficient was the period of loading.

Comparison of the boundary-lubricating ability of bovine synovial fluid, lubricin, and Healon

Purified human umbilical hyaluronate and a commercial preparation of rooster comb hyaluronate (Healon) intended for intra-articular viscosupplementation did not demonstrate the same degree of boundary-lubricating ability as bovine synovial fluid or its purified lubricating mucin, lubricin (p < 0.01). Boundary lubrication was measured in vitro in an arthrotripsometer oscillating natural latex against polished glass under a load of 0.35 MPa with an entraining velocity of 0.37 mm/s. The two hyaluronate solutions possessed the same hyaluronate concentration as synovial fluid, but Healon was 4.5 times more viscous. Present practice of viscosupplementation therapy for degenerative joint disease is limited and fails to implicate the important role of synovial mucin. Boundary lubrication provided by synovial mucin, independent of its viscosity, is not replicated by hyaluronate hydrogels.

The influence of loading time and lubricant on the friction of articular cartilage

Friction of cartilage on metal, metal on cartilage and cartilage on cartilage contact configurations, within a mixed lubrication regime, was measured using synovial fluid, Ringer's solution or with no lubricant present. The main test variable was the period of stationary loading which ranged from 5 s to 45 min, prior to sliding and consequently measuring friction. The coefficient of friction rose gradually with increasing stationary loading time, up to a value of approximately 0.3 at 45 min for all the contact configurations. Following the re-application of load, after short periods of load removal, friction was also found to drop sharply. The flow of liquid in the biphasic cartilage and load carriage by the fluid phase was highlighted as being an important factor in reducing friction within the mixed or boundary lubrication regime. Movement of the contact zone over the cartilage counterface ensured very low friction as the slider moved over fully hydrated cartilage. For the cartilage--cartilage contacts synovial fluid significantly reduced friction compared to Ringer's solution. This was attributed to an effective boundary lubrication action, which was not as effective for the cartilage--metal contacts.

Sliding friction analysis of phosphatidylcholine as a boundary lubricant for articular cartilage

Dipalmitoyl phosphatidylcholine (DPPC), the major lipidic component of the synovial fluid (45 per cent), has been implicated in previous studies in synovial joint lubrication as a potential boundary lubricant for articular cartilage. The purpose of this study was to evaluate the effectiveness of DPPC as a boundary lubricant at physiological stresses experienced by weight-bearing joints (up to 7.5 MPa). The sliding coefficients of static and kinetic friction for glass surfaces coated with DPPC layers of physiological thickness (70 nm) were measured as a function of average contact stress, contact geometry (point and line), applied load and relative velocity (from 25 to 0 mm/s) and compared to the coefficient of friction for clean glass in the same conditions. The coefficient of friction for DPPC-lubricated surfaces was dependent on contact geometry, obeyed Amonton's law (not dependent on axial load or contact area), was dependent on relative velocity within the range stated and was an effective lubricant at physiological stresses. This study showed that dipalmitoyl phosphatidylcholine can be an effective boundary lubricant at stresses observed in load-bearing joints. Because of their surface-active nature, these adsorbed molecules might also act as a protective layer for the articular surfaces.

Cartilage and diarthrodial joints as paradigms for hierarchical materials and structures

The anatomic forms of diarthrodial joints are important structural features which provide and limit the motions required for the joint. Typically, the length scale of topographic variation of anatomic forms ranges from 0.5 to 15 cm. Articular cartilage is the thin layer of hydrated soft tissue (0.5-5.0 mm thick) covering the articulating bony ends in diarthrodial joints. This tissue has a set of unique mechanical and physicochemical properties which are responsible for its load-carrying capabilities and near-frictionless qualities. The mechanical properties of articular cartilage are determined at the tissue-scale level and these properties depend on the composition of the tissue, mainly collagen and proteoglycan, and their molecular and ultrastructural organization (ultra-scale: 10(-8)-10(-6) m). Because proteoglycans possess a high density of fixed negative charges, articular cartilage exhibits a significant Donnan osmotic pressure effect. This physicochemically derived osmotic pressure is an important component of the total swelling pressure; the other component of the total swelling pressure stems from the charge-to-charge repulsive force exerted by the closely spaced (1-1.5 nm) negative charge groups along the proteoglycan molecules. Thus these interactions take place at a nano-scale level: 10(-10)-10(-9) m. Finally, cartilage biochemistry and organization are maintained by the chondrocytes which exist at a micro-scale level (10(-7)-10(-6) m). Significant mechanoelectrochemical transduction occurs within the extracellular matrix at the micro-scale level which affects and modulates cellular anabolic and catabolic activities. At present, the exact details of these transduction mechanisms are unknown. In this review, we present a summary of the hierarchical features for articular cartilage and diarthrodial joints and tables of known material properties for cartilage. Also we summarize how the multi-scale interactions in articular cartilage provide for its unique material properties and tribological characteristics.