Synovial joints

Figure 8.3. Morphological features of a normal and rheumatoid joint (a) the essential features of a healthy synovial joint (e.g. a knee joint) (b) the pathological features of a joint of a patient with rheumatoid arthritis.

Anakinra is the first biologic drug that has been developed specifically as an interleukin (IL)-l receptor antagonist and is derived from an endogenous IL-IRa. The drug blocks the activity of IL-1 in synovial joints, reducing the infiammatory and joint destructive processes associated with rheumatoid arthritis. It is administered subcutaneously and is generally well tolerated. Injection-site reactions are the most commonly reported adverse event. 

Rheumatoid arthritis is a chronic, systemic disorder that affects many different tissues in the body, but is primarily characterized by synovitis and the destruction of articular tissue.49,90 100 This disease is associated with pain, stiffness, and inflammation in the small synovial joints of the hands and feet, as well as in larger joints such as the knee. Although marked by periods of... 

Rheumatoid arthritis and osteoarthritis represent two distinct forms of joint disease that can produce devastating effects on the structure and function of synovial joints. Fortunately, management of these conditions has improved substantially through advancements in drug therapy. Rheumatoid arthritis can be treated pharmacologically with NSAIDs, glucocorticoids, and various DMARDs. NSAIDs, including aspirin, repre-... 

The presence of proteoglycans in the extrafibrillar compartment would result in water depletion in the intrafibrillar compartment when the salinity of the synovial joint, or of the bath in laboratory experiments, is decreased. Therefore there should be mechanisms that retain intrafibrillar water within fibrils. Here, hydration forces that act at short distances, a few angstroms, are postulated to be the main factor that limit the exchangeability of intrafibrillar water. 

Er169 9.4 d Arthritis pain relief in synovial joints... 

Sr90 29.1 y synovial joints By-product of nuclear bomb testing in the atmosphere in the 1940s to 1960s... 

HA is an unsulfated glycosaminoglycane composed of repeating disaccharide units of D-glucuronic acid and A-acetylglucosaminc linked a-( 1 —4) and p-( 1—3), respectively. HA has special importance because it is a component of the ECM [53] in the soft tissues of mammals, where it mainly ensures water retention [54], This enables the transport of nutrients to, and removal of waste from, cells that do not have a direct blood supply, such a cartilage cells. Moreover, HA is present in the synovial joint fluid, the vitreous humor of the eye, cartilage, blood vessels, and the unbilical cord. More detailed information about the biological functions and physicochemical properties of HA can be found elsewhere [55, 56],... 

Inflaimnation of the synovial joints in rhemnatoid arthiitis includes this change in the synovial fluid. 

Mabuchi K, Obara T, Ikegami K et al 1999 Molecular weight independence of the effect of additive hyaluronic acid on the lubricating characteristics in synovial joints with experimental deterioration. Clinical Biomechanics 14 352-356... 

It should be emphasized that the lower frictional coefficient of DN-L gel can be observed under a pressure range of W -lO Pa, which is close to the pressure exerted on articular cartilage in synovial joints. The results demonstrate that the linear polyelectrolyte chains are still effective in maintaining lubrication, even under an extremely high normal pressure. 

Synovium—Synovial membrane, the inner of the two layers of the articular capsule of a synovial joint, composed of loose connective tissue and having a free smooth surface that lines the joint cavity. It secretes the synovial fluid. 

Rheumatoid arthritis is an autoimmune disease that affects multiple synovial joints and involves inflammation of the synovial membrane, often resulting in a loss of function due to the erosion of bone and cartilage [138]. 

CDF/LIF levels are elevated in various inflammatory body fluids (Lotz et al., 1992 Waring et al., 1992 Hamilton et al., 1993 Alexander et al., 1994 Waring et al., 1994a,b). CDF/LIF is produced in articular tissues, and is also detected in synovial joint fluid in patients with rheumatoid arthritis (Lotz et al, 1992). Acute phase proteins are induced by the members of the lL-6 family (Richards et al, 1992 Mayer et al, 1993) and these proteins may play a role in the pathogenesis of rheumatoid arthritis (Blackburn, 1994). CDF/LIF is also present during acute rejection in the urine of kidney graft patients (Taupin et al,... 

The major factors limiting the effective life of a total replacement synovial joint are loosening of one or more of the prosthetic components, a variety of medical problems (e g. infection) and wear. Most internal prostheses now consist of metallic and polymeric components and it is the penetration of the former into the latter which is the subject of this paper. 

The development of satisfactory total replacement synovial joints is sometimes described as the major advance in orthopaedic surgery in recent times. The hip joint was the first major load bearing joint to respond to the efforts of surgeons, engineers and materials scientists in the past two decades to develop satisfactory replacements, but attention is now focussed upon the more complex knee joint. 

The physical dimension of a template defines the boundary of regeneration. Thus, the size of the collagen template should match the tissue defect to be repaired. A properly sized meniscal substitute has been found to function better than a substitute which mismatches the physical dimension of the host meniscus [Rodkey et al., 1998 Sommerlath et al., 1991]. For a porous, elastic matrix such as the one designed from collagen for meniscal tissue repair, the shape of the meniscus is further defined in vivo by the space available between the femoral condyles and tibial plateau within the synovial joint. 

Salter, R.B. 1988. The biologic concept of continuous passive motion of synovial joints. The first 18 years of basic research and its clinical application. Clin. Orthop. 242 12. 

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