The Physiology of Articular Structures

Bauer, Walter; Ropes, Marian W.; Waine, Hans

doi:10.1152/physrev.1940.20.2.272

Cited by 113 publications

(32 citation statements)

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“…An increased albumin/globulin ratio in synovial fluid may also have contributed in some cases. The subatmospheric hydraulic pressures were in keeping with the general concept of 'negative' interstitial fluid pressures (Guyton, 1987), the joint cavity being essentially an extended interstitial space (Bauer et al 1940).…”

Section: Discussionmentioning

confidence: 70%

Synovial Fluid ‐ Its Mass, Macromolecular Content and Pressure in Major Limb Joints of the Rabbit

1988

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SUMMARYSynovial fluid from rabbit elbow, shoulder, hip and knee was analysed to establish the normal levels of parameters relevant to fluid exchange -viz. fluid mass per joint, hydraulic pressure, temperature, colloid osmotic pressure (COP), protein, albumin and glycosaminoglycan (GAG) concentrations. Fluid mass was greatest in the least congruous joint, the shoulder (43 + 4 mg), cf. 6 + 2 mg in the highly congruous hip. In the knee (24+4 mg) the mean thickness of the fluid layer was calculated to be 30,m. Fluid pressure was subatmospheric in all joints (mean -2-8+0-4cmH20, elbow, to -5-7+0-3cmH20, knee), as in many other interstitial spaces.Colloid osmotic pressure was substantial (mean 114+0-9cmH2O, shoulder, to 131+10 cmH20, elbow), being 40-46 % of serum level. Comparison of synovial fluid results with COP versus concentration curves in vitro indicated that the fluid's COP was primarily generated by its protein content (22-30 g 1-1, 64 % albumin) rather than GAG (4 0-5 8 g 1-1). The GAG was 95 % hyaluronate and 5 % sulphated GAG. Algebraic summation of the hydraulic and colloid osmotic pressures of synovial fluid and serum indicated a net filtration gradient from blood to joint cavity. When serum COP was reduced by intravenous saline infusion, synovial fluid mass increased, in accordance with the ultrafiltration hypothesis of synovial fluid formation. The fluid's colloid concentration declined as volume increased. The relation was not a simple dilution curve, but indicated that the newly formed synovial fluid contained > 8 g protein 1-1 (14-5 % serum concentration); and that hyaluronate was entering the synovial cavity at a rate of > 6 5 ,ug h-' per joint.

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Section: Discussionmentioning

confidence: 70%

Synovial Fluid ‐ Its Mass, Macromolecular Content and Pressure in Major Limb Joints of the Rabbit

1988

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“…The intimal channel is assumed to be intercellular, for the intimal cells (modified fibroblasts) have wide intercellular gaps (Ghadially & Roy, 1966) which are permeable to hydrophilic solutes (Ball, Chapman & Muirden 1964;Cochrane, Davies & Palfrey, 1965). Flows are assumed to occur passively down pressure gradients since fluid analysis provides no evidence for active synovial transport (Bauer, Ropes & Waine, 1940 (K5+K,+Kc) In the absence of a synovial microcirculation, flow reduces to I r ue K8+ K, *(J k)-It is reassuring to note that this last equation, which predicts Pk = Pj at ( 1 = 0, yields Pk = -1*1 cm H20, an interstitial pressure similar to those recorded by Snashall, Lucas, Guz & Floyer (1971) and Stromberg & Wiederhielm (1976) (1) Interruption of synovial blood flow did not abolish the phenomenon, which could occur therefore without changes in terms K, and 2PC.…”

Section: Discussionmentioning

confidence: 99%

“…Synovial fluid resembles a plasma ultrafiltrate in protein and electrolyte content (Bauer, Ropes & Waine, 1940), and is therefore presumed to derive from the fluid within synovial capillaries in accordance with the Starling principles (Starling, 1896). Starling's hypothesis of fluid exchange predicts a simple linear relationship, however, between rate of fluid exchange (filtration or absorption) and extravascular pressure; whereas the rate of absorption of intra-articular fluid by synovium is a non-linear function of pressure between 0 and 25 cm H20.…”

mentioning

confidence: 99%

Contributions of the lymphatic and microvascular systems to fluid absorption from the synovial cavity of the rabbit knee.

Levick¹

1980

The Journal of Physiology

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SUMMARY1. The trans-synovial flow (0) of Ringer solution from the cavity of immobile knee (stifle) joints was determined in anaesthetized rabbits when intra-articular hydrostatic pressure (Pj) was elevated in steps from 2 to 25 cm H20.2. It has been demonstrated previously (Levick, 1978) that slope dO8/dPj shows an abrupt sixfold increase at a 'breaking point' (PB) around 9 5 cm H20, rising from a mean of 0 49 ,l. min-' cm H20-1 (PT < PB) to 2-81 ,sl. min-' cm H20-1 (PJ > PB) 3. Perforation of the synovial intima by an intra-articular cannula increased do8/dPj below breaking pressure and thus largely abolished the breaking point phenomenon, indicating that the phenomenon might be simulated by a break-down in synovial resistance to flow.4 6. When the synovial intima was divested of its surrounding tissues, lymphatic and vascular supplies by extensive dissection, the denuded synovium still showed a marked increase in hydraulic conductivity at normal breaking pressures. The breaking point phenomenon was therefore not caused by changes in extra-synovial interstitial pressure or compliance.7. It is concluded that fluid absorption from the joint cavity occurs by two parallel pathways viz. the synovial capillary bed and the extra-synovial interstitial spaces. A simple analysis of the system indicates that the breaking point phenomenon cannot be explained by an abrupt increase in synovial conductivity (cf. Edlund, 1949) but is explicable if synovial conductivity (and possibly interstitial conductivity)

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“…The fact that migration patterns of joint fluid, as demonstrated with the aid of Figures 1, 2 and 3, show electrophoretically well-defined proteins with mobilities similar to those of albumin, a,-, a2-, 8-and 'yglobulin of serum, does not prove chemical identity. The low concentration of albumin and globulin found in normal synovial fluid has generally been ascribed to slight capillary permeability (see review [16]) and the increase in joint effusions is assumed to be due to an alteration in this permeability. The relatively high concentration of albumin in traumatic and in many mild rheumatoid fluids suggests that the normal differential permeability to various protein fractions persists when the inflammation is mild.…”

mentioning

confidence: 99%

The Electrophoretic Patterns of Proteins in Synovial Fluid and Serum in Rheumatoid Arthritis12

Perlmann¹,

Ropes²,

Kaufman³

et al. 1954

J. Clin. Invest.

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The Physiology of Articular Structures

Cited by 113 publications

References 0 publications

Synovial Fluid ‐ Its Mass, Macromolecular Content and Pressure in Major Limb Joints of the Rabbit

Synovial Fluid ‐ Its Mass, Macromolecular Content and Pressure in Major Limb Joints of the Rabbit

Contributions of the lymphatic and microvascular systems to fluid absorption from the synovial cavity of the rabbit knee.

The Electrophoretic Patterns of Proteins in Synovial Fluid and Serum in Rheumatoid Arthritis12

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