Rheology of joint fluid in total knee arthroplasty patients

Abstract

While the properties ofjoint fluid may affect the tribology of joint replacement prostheses, the flow parameters of joint fluid have not yet been examined in the context of total knee arthroplasty (TKA). The objective of this study wils to evaluate the flow properties ofjoint fluids in patients undergoing index TKA or revision TKA. We hypothesized that an alteration of the properties ofjoint fluid would result from TKA. The steady-shear viscosity and storage and loss moduli were evaluated in joint fluid from 35 arthritis patients undergoing TKA, 14 patients undergoing revision of a previous TKA, and two patients presenting with joint effusion after TKA. The same properties were also evaluated in two commercially available sodium hyaluronate preparations and bovine serum, which is used as a lubricant in joint simulators. The steady-shear viscosity varied over three orders of magnitude among samples obtained from patients undergoing TKA, spanning previously established "normal" and "diseased" ranges. Fluid obtained at index TKA was more likely to exhibit normal viscous properties than fluid obtained at revision TKA (p = 0.01). Other viscous parameters distinguished the two groups, but the difference did not reach statistical significance. Both groups exhibited degenerate flow properties when compared to synovial fluid from healthy individuals. Further examination of the connection between flow properties and the tribology of joint replacement prostheses is warranted.

Effects of episodic subluxation events on third body ingress and embedment in the THA bearing surface

“…, representative of human synovial fluid (Mazzucco et al, 2002;Walker et al, 1970), and was chosen over less-viscous bovine calf serum for that reason. To help keep the third body debris suspended, this fluid was actively circulated throughout the test by means of a peristaltic pump ( Figure 1, Figure 2).…”

Efficacy and safety of hylan G-F 20 injection in treatment of knee osteoarthritis in Chinese patients: results of a prospective, multicentre, longitudinal study

“…Surgical therapies mainly entail osteotomy and arthroplasty. 5 Knee OA has been associated with a decrease in the elasticity and viscosity of the synovial fluid, [6][7][8] which may alter the transmission of mechanical forces to the articular cartilage, possibly increasing its susceptibility to mechanical damage, or wear and tear. Viscosupplementation is an intra-articular therapeutic modality based on the physiological importance of hyaluronan in synovial joints.…”

The Synovial Lining and Synovial Fluid Properties after Joint Arthroplasty

“…Studies have found that hyaluronic acid plays a key role in fluid film lubrication and the viscosity of the synovial fluid. Decreased production of HA by type B synoviocytes could explain the decreased viscosity in post arthroplasty fluid and a reciprocal increase of joint wear [37,38]. Lubricin has previously been identified as a key protein in boundary lubrication [55].…”

“…A study by Mazzucco et al [37] examined the flow properties of synovial fluid at the time of total knee arthroplasty (TKA) and at revision. Fifty-eight samples were obtained from patients undergoing index TKA surgery for osteoarthritis, 19 from revision TKA in other patients and two samples from aspirated effused joints that had undergone previous TKA.…”