Multi-lipid synergy in synovial lubrication: natural redundancy vs. natural selection

Abstract: The very low sliding friction of articular cartilage in the major synovial joints such as hips and knees is crucial for their well-being, and has been attributed to lubrication by phospholipid boundary layers. While single-component lipid layers have demonstrated efficient lubricity in model studies, in living joints there is a large number of different lipids, raising the question of whether this is natural redundancy, or whether this multiplicity confers any benefits. Here we examine lubrication by progressively more complex mixtures of lipids representative of those in joints, using a surface forces balance at physiologically-relevant salt concentrations and pressures. We find that different lipid combinations differ very significantly in their lubricating ability, as manifested by their robustness to hemifusion under physiological loads, pointing to a clear lubrication synergy arising from multiple lipid types in the lubricating layers. Insight into the origins of this synergy is provided by molecular dynamics (MD) simulations of the different lipid mixtures used in the experiments, which directly reveal how hemifusion - associated with greatly increased friction - depends on the detailed lipid composition. Our results provide insight into the role of lipid type proliferation in healthy synovial joints, and point to new treatment modalities for osteoarthritis.