Mazzucco Daniel, Spector Myron
Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Clin Orthop Relat Res. 2004 Dec(429):17-32. doi: 10.1097/01.blo.0000150315.47697.b9.
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.
关节液对全髋关节置换术的摩擦学（即润滑、摩擦和磨损）的影响尚未得到充分研究。在本研究中，采用摩擦试验来评估关于人体关节液及其主要成分对金属对聚乙烯关节连接影响的四个假设。首先，发现关节液在钴铬合金和聚乙烯之间产生的摩擦量差异很大；该范围超过了用水或牛血清润滑关节连接时产生的范围。其次，结果表明透明质酸、磷脂、白蛋白和γ球蛋白并非起边界润滑剂的作用，而是一种或多种其他蛋白质（尚未确定）导致了该配对中摩擦力的降低。第三，当氧化锆合金取代钴铬合金作为聚乙烯上的轴承表面时，摩擦力更低。最后，一项初步研究表明，有助于软骨间润滑的润滑素并非导致关节液样本间摩擦学变化的蛋白质。本研究表明，关节液是影响金属对聚乙烯置换术摩擦学的一个患者因素。
