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Orthopaedic journal of sports medicine2014; 2(7); doi: 10.1177/2325967114542580

Synovial Fluid Lubricant Properties are Transiently Deficient after Arthroscopic Articular Cartilage Defect Repair with Platelet-Enriched Fibrin Alone and with Mesenchymal Stem Cells.

Abstract: Following various types of naturally-occurring traumatic injury to an articular joint, the lubricating ability of synovial fluid is impaired, with a correlated alteration in the concentration and/or structure of lubricant molecules, hyaluronan and proteoglycan-4. However, the effect of arthroscopic cartilage repair surgery on synovial fluid lubricant function and composition is unknown. Objective: Arthroscopic treatment of full-thickness chondral defects in horses with (1) platelet-enriched fibrin or (2) platelet-enriched fibrin+mesenchymal stem cells leads to equine synovial fluid with impaired lubricant function and hyaluronan and proteoglycan-4 composition. Methods: Controlled Laboratory Study. Methods: Equine synovial fluid was aspirated from normal joints at a pre-injury state (0 days) and at 10 days and 3 months following fibrin or fibrin+mesenchymal stem cell repair of full thickness chondral defects. Equine synovial fluid samples were analyzed for friction-lowering boundary lubrication of normal articular cartilage (static and kinetic friction coefficients) and concentrations of hyaluronan and proteoglycan-4, as well as molecular weight distribution of hyaluronan. Experimental groups deficient in lubrication function were also tested for the ability of exogenous high-molecular weight hyaluronan to restore lubrication function. Results: Lubrication and biochemical data varied with time after surgery but generally not between repair groups. Relative to pre-injury, kinetic friction was higher (+94%) at 10 days but returned to baseline levels at 3 months while static friction was not altered. Correspondingly, hyaluronan concentration was transiently lower (-64%) and shifted towards lower molecular weight forms, while proteoglycan-4 concentration was increased (+210%) in 10-day samples relative to pre-injury levels. Regression analysis revealed that kinetic friction decreased with increasing total and high molecular weight hyaluronan. Addition of high molecular weight hyaluronan to bring 10-day hyaluronan levels to 2.0mg/ml restored kinetic friction to pre-injury levels. Conclusions: Following arthroscopic surgery for cartilage defect repair, synovial fluid lubrication function is transiently impaired, in association with decreased hyaluronan concentration. This functional deficiency in synovial fluid lubrication can be counteracted in vitro by addition of high molecular weight hyaluronan. Conclusions: Synovial fluid lubrication is deficient shortly following arthroscopic cartilage repair surgery, and supplementation with high molecular weight hyaluronan may be beneficial.
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Publication Date: 2014-12-23 PubMed ID: 25530978PubMed Central: PMC4267539DOI: 10.1177/2325967114542580Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigates how the lubricating functionality of synovial fluid in horses’ joints changes following arthroscopic surgery. Specifically, it examines how the alterations in hyaluronan and proteoglycan-4 molecules affect the fluid’s lubrication function. The study concludes that high molecular weight hyaluronan supplementation can restore normal lubrication following surgery.

Objective and Methods

  • The research aimed to determine how arthroscopic surgery for full-thickness chondral defects in horses, when using platelet-enriched fibrin alone or in combination with mesenchymal stem cells, impacts the synovial fluid of the treated equine joint.
  • Synovial fluid was extracted and analyzed from horses at different time intervals: initially, then 10 days and 3 months after the surgical procedure.
  • Tests were carried out to measure characteristics of the fluid, such as its friction coefficients, concentrations of hyaluronan and proteoglycan-4, and the molecular weight distribution of hyaluronan.
  • The investigation also studied if the addition of exogenous high-molecular weight hyaluronan could improve the fluid’s lubrication function.

Results

  • The study revealed differences in lubrication and biochemical data over time after the repair process, although these changes were not noticeably different between the two repair groups.
  • Kinetic friction rose 94% 10 days after surgery but returned to baseline after 3 months, while static friction remained unchanged.
  • At 10 days post-surgery, hyaluronan concentration was significantly lower (64% reduction), whilst proteoglycan-4 concentration was substantially increased (up by 210%).
  • The addition of high-molecular weight hyaluronan improved the lubrication function, restoring kinetic friction to pre-injury levels.

Conclusions

  • The study concludes that synovial fluid’s lubrication function is temporarily impaired after cartilage defect repair surgery due to a decrease in hyaluronan concentration.
  • Importantly, this deficiency can be overcome by introducing high molecular weight hyaluronan to the synovial fluid.
  • The findings imply that using high molecular weight hyaluronan may assist in achieving better results in post-surgical recovery associated with arthroscopic cartilage repair surgery.

Cite This Article

APA
Grissom MJ, Temple-Wong MM, Adams MS, Tom M, Schumacher BL, McIlwraith CW, Goodrich LR, Chu CR, Sah RL. (2014). Synovial Fluid Lubricant Properties are Transiently Deficient after Arthroscopic Articular Cartilage Defect Repair with Platelet-Enriched Fibrin Alone and with Mesenchymal Stem Cells. Orthop J Sports Med, 2(7). https://doi.org/10.1177/2325967114542580

Publication

Orthopaedic journal of sports medicine
ISSN: 2325-9671
NlmUniqueID: 101620522
Country: United States
Language: English
Volume: 2
Issue: 7

Researcher Affiliations

Grissom, Murray J
  • Murray J. Grissom, MS, Michele M. Temple-Wong, PhD, Matthew S. Adams, BS, Matthew Tom, Barbara L. Schumacher, BS, Robert L. Sah, MD, ScD: University of California, San Diego, La Jolla.
Temple-Wong, Michele M
  • Murray J. Grissom, MS, Michele M. Temple-Wong, PhD, Matthew S. Adams, BS, Matthew Tom, Barbara L. Schumacher, BS, Robert L. Sah, MD, ScD: University of California, San Diego, La Jolla.
Adams, Matthew S
  • Murray J. Grissom, MS, Michele M. Temple-Wong, PhD, Matthew S. Adams, BS, Matthew Tom, Barbara L. Schumacher, BS, Robert L. Sah, MD, ScD: University of California, San Diego, La Jolla.
Tom, Matthew
  • Murray J. Grissom, MS, Michele M. Temple-Wong, PhD, Matthew S. Adams, BS, Matthew Tom, Barbara L. Schumacher, BS, Robert L. Sah, MD, ScD: University of California, San Diego, La Jolla.
Schumacher, Barbara L
  • Murray J. Grissom, MS, Michele M. Temple-Wong, PhD, Matthew S. Adams, BS, Matthew Tom, Barbara L. Schumacher, BS, Robert L. Sah, MD, ScD: University of California, San Diego, La Jolla.
McIlwraith, C Wayne
  • C. Wayne McIlwraith, DVM, PhD, Laurie R Goodrich, DVM, PhD: Colorado State University, Fort Collins, Colorado.
Goodrich, Laurie R
  • C. Wayne McIlwraith, DVM, PhD, Laurie R Goodrich, DVM, PhD: Colorado State University, Fort Collins, Colorado.
Chu, Constance R
  • Constance R. Chu, MD: Stanford University School of Medicine, Stanford, California.
Sah, Robert L
  • Murray J. Grissom, MS, Michele M. Temple-Wong, PhD, Matthew S. Adams, BS, Matthew Tom, Barbara L. Schumacher, BS, Robert L. Sah, MD, ScD: University of California, San Diego, La Jolla.

Grant Funding

  • R01 AR051963 / NIAMS NIH HHS
  • R01 AR055637 / NIAMS NIH HHS
  • RC2 AR058929 / NIAMS NIH HHS
  • T35 AG026757 / NIA NIH HHS
  • R01 AR051565 / NIAMS NIH HHS
  • P01 AG007996 / NIA NIH HHS

Conflict of Interest Statement

One of more of the authors declared the following potential conflict of interest or source of funding: This work was supported by grants from the National Institutes of Health: RC2 AR058929 (to C.R.C.) and R01 AR055637 (to R.L.S.). Additional individual support was received from a UCSD Chancellor’s Research Scholarship (to M.J.G.) and the Medical Student Training in Aging Research Program (to M.J.G.).

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Citations

This article has been cited 8 times.
  1. Vishwanath K, Secor EJ, Watkins A, Reesink HL, Bonassar LJ. Loss of effective lubricating viscosity is the primary mechanical marker of joint inflammation in equine synovitis. J Orthop Res 2024 Jul;42(7):1438-1447.
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  2. Michalaki E, Nepiyushchikh Z, Rudd JM, Bernard FC, Mukherjee A, McKinney JM, Doan TN, Willett NJ, Dixon JB. Effect of Human Synovial Fluid From Osteoarthritis Patients and Healthy Individuals on Lymphatic Contractile Activity. J Biomech Eng 2022 Jul 1;144(7).
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