The effect of lubricant constituents on lubrication mechanisms in hip joint replacements

The effect of albumin and γ-globulin on synovial fluid lubrication: Implication for knee joint replacements

Total knee arthroplasty has become a routine procedure for patients suffering from joint diseases. Although the number of operations continuously increases, a limited service-life of implants represents a persisting challenge for scientists. Understanding of lubrication may help to suitably explain tribological processes on the way to replacements that become durable well into the third decade of service. The aim of the present study is to assess the formation of protein lubricating film in the knee implant. A developed knee simulator was used to observe the contact of real femoral and transparent polymer tibial component using fluorescent microscopy. The contact was lubricated by various protein solutions with attention to the behaviour of albumin and γ-globulin. In order to suitably mimic a human synovial fluid, hyaluronic acid and phospholipids were subsequently added to the solutions. Further, the change in shape and the migration of the contact zone were studied. The results showed considerable appearance differences of the contact over the swing phase of the simplified gait cycle. Regarding film formation, a strong interaction of the various molecules of synovial fluid was observed. It was found that the thickness of the lubricating layer stabilizes within around 50 s. Throughout the contact zone, protein agglomerations were present and could be clearly visualised using the applied optical technique.

On the Dependence of Rheology of Hyaluronic Acid Solutions and Frictional Behavior of Articular Cartilage

Hyaluronic acid (HA) injections represent one of the most common methods for the treatment of osteoarthritis. However, the clinical results of this method are unambiguous mainly because the mechanism of action has not been clearly clarified yet. Viscosupplementation consists, inter alia, of the improvement of synovial fluid rheological properties by injected solution. The present paper deals with the effect of HA molecular weight on the rheological properties of its solutions and also on friction in the articular cartilage model. Viscosity and viscoelastic properties of HA solutions were analyzed with a rotational rheometer in a cone-plate and plate-plate configuration. In total, four HA solutions with molecular weights between 77 kDa and 2010 kDa were tested. The frictional measurements were realized on a commercial tribometer Bruker UMT TriboLab, while the coefficient of friction (CoF) dependency on time was measured. The contact couple consisted of the articular cartilage pin and the plate made from optical glass. The contact was fully flooded with tested HA solutions. Results showed a strong dependency between HA molecular weight and its rheological properties. However, no clear dependence between HA molecular weight and CoF was revealed from the frictional measurements. This study presents new insight into the dependence between rheological and frictional behavior of the articular cartilage, while such an extensive investigation has not been presented before.

Biotribology of Synovial Cartilage: A New Method for Visualization of Lubricating Film and Simultaneous Measurement of the Friction Coefficient

A healthy natural synovial joint is very important for painless active movement of the natural musculoskeletal system. The right functioning of natural synovial joints ensures well lubricated contact surfaces with a very low friction coefficient and wear of cartilage tissue. The present paper deals with a new method for visualization of lubricating film with simultaneous measurements of the friction coefficient. This can contribute to better understanding of lubricating film formation in a natural synovial joint. A newly developed device, a reciprocating tribometer, is used to allow for simultaneous measurement of friction forces with contact visualization by fluorescence microscopy. The software allowing for snaps processing and subsequent evaluation of fluorescence records is developed. The evaluation software and the follow-up evaluation procedure are also described. The experiments with cartilage samples and model synovial fluid are carried out, and the new software is applied to provide their evaluation. The primary results explaining a connection between lubrication and friction are presented. The results show a more significant impact of albumin proteins on the lubrication process, whereas its clusters create a more stable lubrication layer. A decreasing trend of protein cluster count, which corresponds to a decrease in the thickness of the lubrication film, is found in all experiments. The results highlight a deeper connection between the cartilage friction and the lubrication film formation, which allows for better understanding of the cartilage lubrication mechanism.

The Effect of Synovial Fluid Composition, Speed and Load on Frictional Behaviour of Articular Cartilage

Articular cartilage ensures smooth motion of natural synovial joints operating at very low friction. However, the number of patients suffering from joint diseases, usually associated with cartilage degradation, continuously increases. Therefore, an understanding of cartilage tribological behaviour is of great interest in order to minimize its degradation, preserving the reliable function of the joints. The aim of the present study is to provide a comprehensive comparison of frictional behaviour of articular cartilage, focusing on the effect of synovial fluid composition (i), speed (ii), and load (iii). The experiments were realized using a pin-on-plate tribometer with reciprocating motion. The articular cartilage pin was loaded against smooth glass plate while the tests consisted of loading and unloading phases in order to enable cartilage rehydration. Various model fluids containing albumin, γ-globulin, hyaluronic acid, and phospholipids were prepared in two different concentrations simulating physiologic and osteoarthritic synovial fluid. Two different speeds, 5 mm/s and 10 mm/s were applied, and the tests were carried out under 5 N and 10 N. It was found that protein-based solutions exhibit almost no difference in friction coefficient, independently of the concentration of the constituents. However, the behaviour is considerably changed when adding hyaluronic acid and phospholipids. Especially when interacting with γ-globulin, friction coefficient decreased substantially. In general, an important role of the interaction of fluid constituents was observed. On the other hand, a limited effect of speed was detected for most of the model fluids. Finally, it was shown that elevated load leads to lower friction, which corresponds well with previous observations. Further study should concentrate on specific explored phenomena focusing on the detailed statistical evaluation.

The Effect of Kinematic Conditions and Synovial Fluid Composition on the Frictional Behaviour of Materials for Artificial Joints

The paper introduces an experimental investigation of frictional behaviour of materials used for joint replacements. The measurements were performed using a ball-on-disc tribometer, while four material combinations were tested; metal-on-metal, ceramic-on-ceramic, metal-on-polyethylene, and ceramic-on-polyethylene, respectively. The contact was lubricated by pure saline and various protein solutions. The experiments were realized at two mean speeds equal to 5.7 mm/s and 22 mm/s and two slide-to-roll ratios, −150% and 150%. It was found that the implant material is the fundamental parameter affecting friction. In general, the metal pair exhibited approximately two times higher friction compared to the ceramic. In particular, the friction in the case of the metal varied between 0.3 and 0.6 while the ceramic pair exhibited friction within the range from 0.15 to 0.3 at the end of the test. The lowest friction was observed for polyethylene while it decreased to 0.05 under some conditions. It can be also concluded that adding proteins to the lubricant has a positive impact on friction in the case of hard-on-hard pairs. For hard-on-soft pairs, no substantial influence of proteins was observed. The effect of kinematic conditions was found to be negligible in most cases.

Regression models to predict the behavior of the coefficient of friction of AISI 316L on UHMWPE under ISO 14243-3 conditions

Friction is the natural response of all tribosystems. In a total knee replacement (TKR) prosthetic device, its measurement is hindered by the complex geometry of its integrating parts and that of the testing simulation rig operating under the ISO 14243-3:2014 standard. To develop prediction models of the coefficient of friction (COF) between AISI 316L steel and ultra-high molecular weight polyethylene (UHMWPE) lubricated with fetal bovine serum dilutions, the arthrokinematics and loading conditions prescribed by the ISO 142433: 2014 standard were translated to a simpler geometrical setup, via Hertz contact theory. Tribological testing proceeded by loading a stainless steel AISI 316L ball against the surface of a UHMWPE disk, with the test fluid at 37 °C. The method has been applied to study the behavior of the COF during a whole walking cycle. On the other hand, the role of protein aggregation phenomena as a lubrication mechanism has been extensively studied in hip joint replacements but little explored for the operating conditions of a TKR. Lubricant testing fluids were prepared with fetal bovine serum (FBS) dilutions having protein mass concentrations of 5, 10, 20 and 36 g/L. The results were contrasted against deionized, sterilized water. The results indicate that even at protein concentration as low as 5 g/L, protein aggregation phenomena play an important role in the lubrication of the metal-on-polymer tribopair. The regression models of the COF developed herein are available for numerical simulations of the tribological behavior of the aforementioned tribosystem. In this case, surface stress rather than film thickness should be considered.