Tribological changes in the articular cartilage of a human femoral head with avascular necrosis.

The present study evaluated the tribological properties of the articular cartilage surface of the human femoral head with postcollapse stage avascular necrosis (AVN) using atomic force microscopy. The cartilage surface in the postcollapse stage AVN of the femoral head was reported to resemble those of disuse conditions, which suggests that the damage could be reversible and offers the possibilities of success of head-sparing surgeries. By comparing the tribological properties of articular cartilage in AVN with that of osteoarthritis, the authors intended to understand the cartilage degeneration mechanism and reversibility of AVN. Human femoral heads with AVN were explanted from the hip replacement surgery of four patients (60-83 years old). Nine cylindrical cartilage samples (diameter, 5 mm and height, 0.5 mm) were sectioned from the weight-bearing areas of the femoral head with AVN, and the cartilage surface was classified according to the Outerbridge Classification System (AVN0, normal; AVN1, softening and swelling; and AVN2, partial thickness defect and fissuring). Tribological properties including surface roughness and frictional coefficients and histochemistry including Safranin O and lubricin staining were compared among the three groups. The mean surface roughness Rq values of AVN cartilage increased significantly with increasing Outerbridge stages: Rq = 137 ± 26 nm in AVN0, Rq = 274 ± 49 nm in AVN1, and Rq = 452 ± 77 nm in AVN2. Significant differences in Rq were observed among different Outerbridge stages in all cases (p < 0.0001). The frictional coefficients (µ) also increased with increasing Outerbridge stages. The frictional coefficient values were µ = 0.115 ± 0.034 in AVN0, µ = 0.143 ± 0.025 in AVN1, and µ = 0.171 ± 0.039 in AVN2. Similarly to the statistical analysis of surface roughness, significant statistical differences were detected between different Outerbridge stages in all cases (p < 0.05). Both surface roughness and frictional coefficient of cartilage, which were linearly correlated, increased with increasing Outerbridge stages in postcollapse AVN. The underlying mechanism of these results can be related to proteoglycan loss within the articular cartilage that is also observed in osteoarthritis. With regard to the tribological properties, the cartilage degeneration mechanism in AVN was similar to that of osteoarthritis without reversibility.

Effects of hyaluronic acid and γ-globulin concentrations on the frictional response of human osteoarthritic articular cartilage.

Synovial fluid plays an important role in lubricating synovial joints. Its main constituents are hyaluronic acid (HA) and γ-globulin, acting as boundary lubricants for articular cartilage. The aim of the study was to demonstrate the concentration-dependent effect of HA and γ-globulin on the boundary-lubricating ability of human osteoarthritis (OA) cartilage. Normal, early and advance stage articular cartilage samples were obtained from human femoral heads and in presence of either HA or γ-globulin, cartilage frictional coefficient (µ) was measured by atomic force microscopy (AFM). In advanced stage OA, the cartilage superficial layer was observed to be completely removed and the damaged cartilage surface showed a higher µ value (∼ 0.409) than the normal cartilage surface (∼ 0.119) in PBS. Adsorbed HA and γ-globulin molecules significantly improved the frictional behavior of advanced OA cartilage, while they were ineffective for normal and early OA cartilage. In advanced-stage OA, the concentration-dependent frictional response of articular cartilage was observed with γ-globulin, but not with HA. Our result suggested that HA and γ-globulin may play a significant role in improving frictional behavior of advanced OA cartilage. During early-stage OA, though HA and γ-globulin had no effect on improving frictional behavior of cartilage, however, they might contribute to disease modifying effects of synovial fluid as observed in clinical settings.

Role of hyaluronic acid and phospholipid in the lubrication of a cobalt-chromium head for total hip arthroplasty.

The tribological performance of total hip arthroplasty has an important influence on its success rate. This study examined the concentration-dependent role of hyaluronic acid (HA) and phospholipid (dipalmitoylphosphatidylcholine, DPPC) in the boundary lubricating ability of retrieved cobalt-chromium femoral heads. The microscale frictional coefficients (µ) were measured by atomic force microscopy using a rectangular silicon cantilever integrated with sharp silicon tips. In the case of HA lubricant, the frictional coefficients decreased significantly at concentrations of 2.0 (0.16 ± 0.03) and 3.5 mg/ml (0.11 ± 0.01) while increased at 5.0 mg/ml (0.15 ± 0.01), compared to that with phosphate buffer saline (0.25 ± 0.03). The concentration-dependent lubrication behavior of DPPC was most effective when DPPC was in the physiological concentration range, showing µ = 0.16 ± 0.01 in polypropylene glycol, and 0.05 ± 0.01, 0.02 ± 0.01, and 0.03 ± 0.01 at a DPPC concentration of 0.05, 0.2, and 3.0 mg/ml, respectively. Results obtained show significant differences between the DPPC concentration groups. Conclusively, the microscale frictional response of the retrieved CoCr femoral head has a significant dependence on the concentrations of HA and DPPC. Moreover, observed optimal concentration of HA and DPPC for effective lubrication is similar to that observed in normal human synovial fluid. Therefore, a retrieval of the synovia may be considered during total hip replacement surgeries in an effort for reduction of friction between head and liner of total hip replacement implants.

Frictional response of normal and osteoarthritic articular cartilage in human femoral head.

We evaluated the microscale frictional response of human articular cartilage in different osteoarthritis stages using an atomic force microscope. Four human femoral heads (60-80 years old) with different osteoarthritis stages were explanted, and two cylindrical cartilage samples were sectioned from each femoral head. The microscale frictional coefficient mu of human cartilage in phosphate-buffered saline increased with increasing osteoarthritis stages, resulting in mu = 0.119 +/- 0.036 for stage 0 (normal cartilage), 0.151 +/- 0.039 for stage I, 0.158 +/- 0.041 for stage 2, and 0.409 +/- 0.119 for stage 3. Statistically significant differences of mu values for different osteoarthritis stages were detected only between stage 3 and other stages (p < 0.0001). The average surface roughness Rq significantly increased with increasing osteoarthritis stages, ranging from 137 +/- 25 nm for stage 0 to 533 +/- 196 nm for stage 3. A significant correlation between mu and Rq for different osteoarthritis stages was observed (R2 = 0.981). These results demonstrate a positive correlation between the osteoarthritis stages and cartilage surface roughness, and the dependence of the human cartilage frictional response, on osteoarthritis progression. The results could be due to a decrease in the superficial zone protein concentration during the natural progression of osteoarthritis.

Effect of protein concentrations of bovine serum albumin and γ-globulin on the frictional response of a cobalt-chromium femoral head.

The study aims to identify the concentration-dependent role of bovine serum albumin (BSA) and γ-globulin in the lubricating ability of a cobalt-chromium femoral head. The frictional coefficients of the cobalt-chromium femoral head decreased with increasing BSA concentrations from 10 to 40 mg/ml and showed statistical differences between any of the BSA concentration groups, except between the 30 and 40 mg/ml concentration groups. In γ-globulin, the frictional coefficients significantly decreased at concentrations of 2.5 and 5.0 mg/ml as compared with the PBS control group, but significant increases were observed at 7.5 and 12.5 mg/ml. These results suggest that the friction of the cobalt-chromium femoral head is dependent on the concentration of both BSA and γ-globulin. However, there is a maximum concentration for BSA to act as an effective boundary lubricant, while the lubricating ability of γ-globulin is most effective in the physiological concentration range within human synovial fluid.

The Tribological and Lubrication Responses of a Cobalt-Chromium Femoral Head in Total Hip Arthroplasty

PURPOSE: This study aimed at investigating the role of albumin as a boundary lubricant in the lubrication of the Co-Cr femoral head of artificial hip implants by measuring the tribological parameters of the Co-Cr femoral head with Atomic Force Microscope (AFM) techniques. MATERIALS AND METHODS: Samples were prepared from the main wear region of a Co-Cr femoral head from revision hip surgery. Two types of solutions were prepared as lubricants: PBS (Phosphate Buffered Saline) as a control solution and BSA (Bovine Serum Albumin) as a lubricant at concentrations of 10, 20, 30 and 40 mg/ml in PBS solution. RESULTS: There were statistically significant differences in the frictional coefficients (micron) of a Co-Cr head between the PBS control and all the concentrations of BSA (10, 20, 30, 40 mg/ml) (P<0.001). Similarly, there were statistically significant differences for the micron between the BSA concentrations of 10, 20, 30 and 40 mg/m for all the cases except between the BSA of 30 and 40 mg/ml (P<0.01). CONCLUSION: There exists a maximum protein concentration of BSA to play a role as an effective boundary lubricant through adsorption on the surface of Co-Cr femoral head.