It's always good to get more information; it can't help but keep us knowledgeable about our implants.
I'm curious what the impact of these findings is. It seems that in osteoarthritis, one of the side 'benefits' is inflammation of the synovial membrane. This can cause increase in volume of the synovial fluid within the hip.
Synovial fluid, though seems to be this amazing compound that is built to deal with not just lubrication in the traditional sense (surfaces sliding across each other), but also to provide buffering as pressure is applied. So it works on motion and on weight being applied.
The measure of how effective it is seems to be based on its main 'sliding' component, hyaluronic acid. This is what grabs on to surfaces of healthy cartilage and healthy bone and lubricates all movement. In our case, it probably grabs on to the metal surfaces and lubricates away.
What can compromise hyularonic acid is anything that digests it. Although if its not digested, but just broken into chunks, it still is able to perform correctly.
Synovial fluid as a whole has been identified as comparable to blood plasma, so coagulation can take part in it. So anything that introduces the components of coagulation, like inflammation, may increase clotting within the synovial fluid and so volume.
In Degenerative Joint Disease (osteoarthritis, which we had), as the linked article notes,
"The synovial fluid from joints with degenerative joint disease is usually clear, although haziness or flocculence due to cells and cartilaginous debris may be found. The fluid is usually pale yellow to straw-colored.
Unless significant joint effusion is present, viscosity is normal, and the mucin clot is usually rated fair to good. Protein and glucose values usually remain unchanged, although a slight reduction in glucose can occur in fluids with increased cellularity due to glycolytic activity of the cells.(20) Low glucose values must be interpreted in light of any delays in synovial fluid analysis.
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Which points to less impact from blood clotting within the synovial fluid from osteoarthritis. If this also means no interference with the hyaluronic acid, then the synovial fluid itself is still active as normal.
I think this research is a valuable new way to look at our HRs. The more we know, the better off we are. The questions I have are:
- Does this impact my ability to move, etc. If I'm asymptomatic? It seems based on the above that the synovial fluid, unless enzymes are introduced that will digest hyaluronic acid, will continue to be my friend, and I can move to my rhythm.
- If the synovial membrane is irritated in a low level, is that a steady state issue (will it stay at that level) or does it inexorably progress to a worse state? It seems like many more hippys would be complaining of pain if that were the case, but I would like to see more studies of that possibility
- Synovial fluid can be extracted without surgery, if the levels of metals are an issue, can that or other treatments be used to lower the inflammation.
- How does the membrane's inflammation complicate a revision? Ideally we won't need one, but if I need one, am I really complicating things by having an asymptomatic, low level inflammation?
I'm not a medical person, although at one time did do medical research. Anything that adds to our knowledge is a good thing to me. These are some of my questions, I'm sure there are a lot more things others can think of.
I like to face things head on, so had to think about this a bit. I see a bit of good initial research that needs to be expanded on. I'm thankful that they are looking at things in a different way; it may point to ways of treating this early so we lower the revision rate.
The quote I used was from a paper that is very interesting and extensive; it is a veterinary paper, but applies to humans and treats with synovial fluid well from my limited perspective
http://cal.vet.upenn.edu/projects/saortho/chapter_86/86mast.htm