title: The John Charnley Award Paper. The role of joint fluid in the tribology of total joint arthroplasty.
abstract: The effect of joint fluid on the tribology (ie, lubrication, friction, and wear) of total hip arthroplasty has not yet been investigated adequately. In the current study, a friction assay was used to assess four hypotheses relating to the effect of human joint fluid and its principal components on the articulation of metal-on-polyethylene. First, joint fluid was found to produce a widely varying amount of friction between cobalt-chromium and polyethylene; this range exceeded the range produced when the articulation was lubricated by water or bovine serum. Second, it was shown that hyaluronic acid, phospholipid, albumin, and gamma-globulin were not acting as boundary lubricants, but that one or more other proteins (as yet unidentified) were responsible for reducing friction in this couple. Third, lower friction was found when oxidized zirconium alloy replaced cobalt-chromium as a bearing surface on polyethylene. Finally, a pilot study suggested that lubricin, which contributes to cartilage-on-cartilage lubrication, is not a protein responsible for the tribological variabiation found among joint fluid samples. The current study showed that joint fluid is a patient factor that influences the tribology of metal-on-polyethylene arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mazzucco
authors.forename: Myron
authors.initials: M
authors.lastname: Spector
mesh_terms: D000818:Animals; D019643:Arthroplasty, Replacement / Q000379:methods*; D001363:Awards and Prizes; D001672:Biocompatible Materials; D001696:Biomechanical Phenomena; D001858:Bone Nails; D002417:Cattle; D017276:Friction; D006621:Hip Joint / Q000502:physiology / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D007700:Kinetics; D007719:Knee Joint / Q000502:physiology / Q000601:surgery; D007720:Knee Prosthesis; D008153:Lubrication; D020959:Polyethylene; D011474:Prosthesis Design; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D013582:Synovial Fluid / Q000502:physiology*; D016474:Weight-Bearing
chemical_list: D001672:Biocompatible Materials; D020959:Polyethylene