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Related Experiment Videos

Surface-active phospholipid in total hip arthroplasty.

Bodo Purbach1, Brian A Hills, B Michael Wroblewski

  • 1Wrightington Hospital for Joint Disease, Appley Bridge, Wigan, United Kingdom.

Clinical Orthopaedics and Related Research
|February 23, 2002
PubMed
Summary

Surface-active phospholipids act as crucial boundary lubricants in total hip arthroplasty, consistently produced by the body long after surgery. This natural lubricant is present on all implant materials, ensuring joint function.

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Area of Science:

  • Biomaterials Science
  • Orthopedic Surgery
  • Lubrication Engineering

Background:

  • Total hip arthroplasty (THA) involves artificial joint surfaces that require effective lubrication for longevity.
  • The precise lubricating mechanisms within THA, especially long-term, remain incompletely understood.
  • Surface-active phospholipids (SAPs) are known biological lubricants, but their role in THA was previously unreported.

Purpose of the Study:

  • To investigate the presence and significance of surface-active phospholipids as boundary lubricants in total hip arthroplasty.
  • To determine if SAP production persists post-surgery and is independent of implant type or fixation.

Main Methods:

  • Analysis of synovial fluid aspirates and joint rinsing samples from 26 patients (25 revision, 1 primary THA).

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  • Samples were collected between 3 weeks and 26 years post-operation.
  • Quantification of surface-active phospholipids using established biochemical assays.

    • Main Results:

    • Substantial quantities of surface-active phospholipids (14–4186 µg) were detected in all analyzed samples.
    • SAPs were identified on diverse bearing surface materials, including polyethylene, stainless steel, chrome cobalt, alumina, zirconia, and titanium.
    • Consistent presence of SAPs suggests continuous production by synoviocytes.

    Conclusions:

    • Surface-active phospholipids are a significant boundary lubricant within the total hip arthroplasty joint.
    • Synoviocytes actively produce SAPs in considerable amounts, irrespective of arthroplasty type or fixation.
    • These findings highlight a critical, naturally occurring lubrication mechanism essential for joint implant function and longevity.