The Effect of Experimental Cartilage Damage and Impairment and Restoration of Synovial Lubrication on Friction in the Temporomandibular Joint

Aims: To evaluate how the frictional coefficient of the porcine temporomandibular joint (TMJ) is affected by an impairment of the synovial lubrication produced by an experimental abrasion of the articular cartilage and the application of hyaluronic acid (HA) with different molecular weights to the abraded cartilage surfaces. Methods: Erosion of the articular cartilage was produced by scouring it with sandpaper. Impairment and restoration of syn-ovial lubrication were modeled by washing the joint space with phosphate-buffered saline (PBS) and by the application of HA with different molecular weights. After measuring the frictional coefficients in the intact TMJs (n = 10), the effects of washing with PBS, sandpaper scouring, and the application of HA were subse-quently examined. Results: The mean frictional coefficient in the intact joint was 0.0154 (SD 0.0043). After PBS washing and sand-paper scouring, it increased significantly to 0.0235 (SD 0.0052) and 0.0520 (SD 0.0088), respectively. Subsequent application of HA resulted in a significant decrease (43% to 56%) of the fric-tional coefficient. Observations by scanning electron microscopy showed that after sandpaper scouring, the superficial cartilage layer was disrupted and inner layer was exposed, creating an irreg-ular surface. Conclusion: Joint friction may increase by approxi-mately 350% following an experimental scouring of the cartilage surface and impairment of synovial lubrication. Lubrication by means of HA decreased joint friction by approximately 50%.

frictional coefficient; hyaluronic acid; lubrication; osteoarthritis; temporomandibular joint

1. Nickel JC, McLachlan KR. In vitro measurement of the frictional properties of the temporomandibular joint disc. Arch Oral Biol 1994;39:323–331.

2. Tanaka E, Kawai N, Tanaka M, et al. The frictional coefficient of the temporomandibular joint and its dependency on the magnitude and duration of joint loading. J Dent Res 2004;83:404–407.

3. Forster H, Fisher J. The influence of loading time and lubricant on the friction of the articular cartilage. Proc Inst Mech Eng [H] 1996;210:109–119.

4. Forster H, Fisher J. The influence of continuous sliding and subsequent surface wear on the friction of the articular cartilage. Proc Inst Mech Eng [H] 1999;213:329–345.

5. Sundblad L. Glycosaminoglycans and glycoproteins in synovial fluid. In: Balazs EA, Jeanloz RW (eds). The Chemistry and Biology of Compounds Containing Amino Sugars. I: The amino sugars. New York: Academic Press, 1965:229–250.

6. Yamaki T, Yamaguchi T. Temporary network formation of hyaluronate under a physiological condition. 1. Molecular-weight dependence. Biopolymers 1990;30: 415–425.

7. Kobayashi Y, Okamoto A, Nishinari K. Viscoelasticity of hyaluronic acid with different molecular weights. Biorheology 1994;31:235–244.

8. Mabuchi K, Obara T, Ikegami K, Yamaguchi T, Kanayama T. Molecular weight independence of the effect of additive hyaluronic acid on the lubricating characteristics in synovial joints with experimental deterioration. Clin Biomech (Bristol, Avon) 1999;14:352–356.

9. Nitzan DW, Nitzan U, Dan P, Yedgar S. The role of hyaluronic acid in protecting surface-active phospholipids from lysis by exogenous phospholipase A2. Rheumatol 2001;40:336–340.

10. Kopp S. Topographical distribution of sulphated glycosaminoglycans in human temporomandibular joint disks. A histochemical study of an autopsy material. J Oral Pathol 1976;5:265–276.

11. Mori S, Naito M, Moriyama S. Highly viscous sodium hyaluronate and joint lubrication. Int Orthop 2002;26:116–121.

12. Imada M, Tanimoto K, Ohno S, Sasaki A, Sugiyama H, Tanne K. Changes in urinary bone resorption markers (pyridinoline, deoxypyridinoline) resulting from experi-mentally-induced osteoarthritis in the temporomandibular joint of rats. Cranio 2003;21:38–45.

13. Balazs EA, Denlinger J. Viscosupplementation: A new concept in the treatment of osteoarthritis. J Rheumatol 1993;39(suppl):3–9.

14. Tsukamoto, Y, Kondo H. The measurement of the viscosity of synovial fluid. Seikeigeka 1980;31:1257–1265.

15. Tsukamoto Y, Mabuchi T, Futami T, Kubotera D. Motion of the bipolar hip prosthesis components. Acta Orthop Scand 1992;42:476–485.

16. Kawai N, Tanaka E, Takata T, et al. The influence of additive hyaluronic acid on the lubricating ability in the temporomandibular joint. J Biomed Mater Res 2004;70A:149–153.

17. Gallo LM, Nickel JC, Iwasaki LR, Palla S. Stress-field translation in the healthy human temporomandibular joint. J Dent Res 2000;79:1740–1746.

18. Bermejo A, Gonzalez O, Gonzalez JM. The pig as an animal model for experimentation on the temporomandibular articular complex. Oral Surg Oral Med Oral Pathol 1993;75:18–23.

19. Langenbach G, van Eijden TMGJ. Mammalian feeding motor patterns. Amer Zool 2001;41:1338–1351.

20. Sun Z, Liu ZJ, Herring SW. Movement of temporo-mandibular joint tissues during mastication and passive manipulation in miniature pigs. Arch Oral Biol 2002;47:293–305.

21. Radin EL, Swann DA, Weisser PA. Separation of a hyaluronate-free lubricating fraction from synovial fluid. Nature 1970;228:377–378.

22. Jay GD, Haberstroh K, Cha CJ. Comparison of the boundary-lubricating ability of bovine synovial fluid, lubricin and Healon. J Biomed Mater Res 1998;40:414–418.

23. Obara T, Mabuchi K, Iso T, Yamaguchi T. Increased friction of animal joints by experimental degradation and recovery by addition of hyaluronic acid. Clin Biomech 1997;12:246–252.

24. Nitzan DW. The process of lubrication impairment and its involvement in temporomandibular joint disc displacement: A theoretical concept. J Oral Maxillofac Surg 2001;59:36–45.

25. Rydell N, Balaz EA. Effects of intra-articular injections of hyaluronic acid on the clinical symptoms of osteoarthritis and on granulation tissue formation. Clin Orthop 1971;80:25–32.

26. Neo H, Ishimaru JI, Kurita K, Goss AN. The effect of hyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep. J Oral Maxillofac Surg 1997;55:1114–1119.

27. Fujii K, Kawata M, Kobayashi Y, Okamoto A, Nishinari K. Effects of the addition of hyaluronate segments with different chain lengths on the viscoelasticity of hyaluronic acid solutions. Biopolymers 1996;38:583–591.