Abstract

Trans-synovial solute transport plays a critical role in the clearance of intra-articularly (IA) delivered drugs. In this study, we present a computational finite element model (FEM) of solute transport through the synovium validated by experiments on synovial explants. Unsteady diffusion of urea, a small uncharged molecule, was measured through devitalized porcine and human synovium using custom-built diffusion chambers. A multiphasic computational model was constructed and optimized with the experimental data to extract effective diffusivity for urea within the synovium. A monotonic decrease in urea concentration was observed in the donor bath over time, with an effective diffusivity found to be an order of magnitude lower in synovium versus that measured in free solution. Parametric studies incorporating an intimal cell layer with varying thickness and varying effective diffusivities were performed, revealing a dependence of drug clearance kinetics on both parameters. The findings of this study indicate that the synovial matrix impedes urea solute transport out of the joint with little retention of the solute in the matrix.

References

1.
Cross
,
M.
,
Smith
,
E.
,
Hoy
,
D.
,
Nolte
,
S.
,
Ackerman
,
I.
,
Fransen
,
M.
,
Bridgett
,
L.
,
Williams
,
S.
,
Guillemin
,
F.
,
Hill
,
C. L.
,
Laslett
,
L. L.
,
Jones
,
G.
,
Cicuttini
,
F.
,
Osborne
,
R.
,
Vos
,
T.
,
Buchbinder
,
R.
,
Woolf
,
A.
, and
March
,
L.
,
2014
, “
The Global Burden of Hip and Knee Osteoarthritis: Estimates From the Global Burden of Disease 2010 Study
,”
Ann. Rheum. Dis.
,
73
(
7
), pp.
1323
1330
.10.1136/annrheumdis-2013-204763
2.
United States Bone and Joint Initiative,
2014
, “United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS),” Rosemont, IL, accessed Jan. 2019, http://www.boneandjointburden.org
3.
Larsen
,
C.
,
Østergaard
,
J.
,
Larsen
,
S. W.
,
Jensen
,
H.
,
Jacobsen
,
S.
,
Lindegaard
,
C.
, and
Andersen
,
P. H.
,
2008
, “
Intra-Articular Depot Formulation Principles: Role in the Management of Postoperative Pain and Arthritic Disorders
,”
J. Pharm. Sci.
,
97
(
11
), pp.
4622
4654
.10.1002/jps.21346
4.
Hootman
,
J. M.
,
Helmick
,
C. G.
,
Barbour
,
K. E.
,
Theis
,
K. A.
, and
Boring
,
M. A.
,
2016
, “
Updated Projected Prevalence of Self-Reported Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation Among U.S. Adults, 2015-2040 HHS Public Access
,”
Arthritis Rheumatol.
,
68
(
7
), pp.
1582
1587
.10.1002/art.39692
5.
Barbour
,
K. E.
,
Helmick
,
C. G.
,
Boring
,
M.
, and
Brady
,
T. J.
,
2017
, “
Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation—United States, 2013–2015
,”
MMWR. Morb. Mortal. Wkly. Rep.
,
66
(
9
), pp.
246
53
.10.15585/mmwr.mm6609e1
6.
Genovese
,
M. C.
,
Bathon
,
J. M.
,
Fleischmann
,
R. M.
,
Moreland
,
L. W.
,
Martin
,
R. W.
,
Whitmore
,
J. B.
,
Tsuji
,
W. H.
, and
Leff
,
J. A.
,
2005
, “
Longterm Safety, Efficacy, and Radiographic Outcome With Etanercept Treatment in Patients With Early Rheumatoid Arthritis
,”
J. Rheumatol.
,
32
(
7
), pp.
1232
1242
.https://www.ncbi.nlm.nih.gov/pubmed/15996057
7.
Elliott
,
M.
,
Maini
,
R.
,
Feldmann
,
M.
,
Kalden
,
J.
,
Antoni
,
C.
,
Smolen
,
J.
,
Leeb
,
B.
,
Breedveld
,
F.
,
Macfarlane
,
J.
,
Bijl
,
J.
, and
Woody
,
J.
,
1994
, “
Randomised Double-Blind Comparison of Chimeric Monoclonal Antibody to Tumour Necrosis Factor α (CA2) Versus Placebo in Rheumatoid Arthritis
,”
Lancet
,
344
(
8930
), pp.
1105
10
.10.1016/S0140-6736(94)90628-9
8.
Chevalier
,
X.
, and
Kemta-Lepka
,
F.
,
2010
, “
Are Biologics a Treatment Option in Osteoarthritis?
,”
Therapy
,
7
(
6
), pp.
675
83
.10.2217/thy.10.66
9.
Jones
,
I. A.
,
Togashi
,
R.
,
Wilson
,
M. L.
,
Heckmann
,
N.
, and
Vangsness
,
C. T.
,
2019
, “
Intra-Articular Treatment Options for Knee Osteoarthritis
,”
Nat. Rev. Rheumatol.
,
15
(
2
), pp.
77
90
.10.1038/s41584-018-0123-4
10.
Evans
,
C. H.
,
Kraus
,
V. B.
, and
Setton
,
L. A.
,
2014
, “
Progress in Intra-Articular Therapy
,”
Nat. Rev. Rheumatol.
,
10
(
1
), pp.
11
22
.10.1038/nrrheum.2013.159
11.
Gerwin
,
N.
,
Hops
,
C.
, and
Lucke
,
A.
,
2006
, “
Intraarticular Drug Delivery in Osteoarthritis B
,”
Adv. Drug Deliv. Rev.
,
58
(
2
), pp.
226
42
.10.1016/j.addr.2006.01.018
12.
Wallis
,
W. J.
,
Simkin
,
P. A.
,
Nelp
,
W. B.
, and
Foster
,
D. M.
,
1985
, “
Intraarticular Volume and Clearance in Human Synovial Effusions
,”
Arthritis Rheum.
,
28
(
4
), pp.
441
9
.10.1002/art.1780280413
13.
Burt
,
H. M.
,
Tsallas
,
A.
,
Gilchrist
,
S.
, and
Liang
,
L. S.
,
2009
, “
Intraarticular Drug Delivery Systems: Overcoming the Shortcomings of Joint Disease Therapy
,”
Expert Opin. Drug Deliv.
,
6
(
1
), pp.
17
26
.10.1517/17425240802647259
14.
Hui
,
A. Y.
,
McCarty
,
W. J.
,
Masuda
,
K.
,
Firestein
,
G. S.
, and
Sah
,
R. L.
,
2012
, “
A Systems Biology Approach to Synovial Joint Lubrication in Health, Injury, and Disease
,”
Wiley Interdiscip. Rev. Syst. Biol. Med.
,
4
(
1
), pp.
15
37
.10.1002/wsbm.157
15.
Revell
,
P. A.
,
Al-Saffar
,
N.
,
Fish
,
S.
, and
Osei
,
D.
,
1995
, “
Extracellular Matrix of the Synovial Intimal Cell Layer
,”
Ann. Rheum. Dis.
,
54
(
5
), pp.
404
407
.10.1136/ard.54.5.404
16.
Knight
,
A. D.
, and
Levick
,
J. R.
,
1984
, “
Morphometry of the Ultrastructure of the Blood-Joint Barrier in the Rabbit Knee
,”
Q. J. Exp. Physiol.
,
69
(
2
), pp.
271
288
.10.1113/expphysiol.1984.sp002805
17.
Conaghan
,
P. G.
,
Hunter
,
D. J.
,
Cohen
,
S. B.
,
Kraus
,
V. B.
,
Berenbaum
,
F.
,
Lieberman
,
J. R.
,
Jones
,
D. G.
,
Spitzer
,
A. I.
,
Jevsevar
,
D. S.
,
Katz
,
N. P.
,
Burgess
,
D. J.
,
Lufkin
,
J.
,
Johnson
,
J. R.
, and
Bodick
,
N.
,
2018
, “
Effects of a Single Intra-Articular Injection of a Microsphere Formulation of Triamcinolone Acetonide on Knee Osteoarthritis Pain
,”
J. Bone Jt. Surg.
,
100
(
8
), pp.
666
677
.10.2106/JBJS.17.00154
18.
Kraus
,
V. B.
,
Conaghan
,
P. G.
,
Aazami
,
H. A.
,
Mehra
,
P.
,
Kivitz
,
A. J.
,
Lufkin
,
J.
,
Hauben
,
J.
,
Johnson Yy
,
J. R.
, and
Bodick
,
N.
,
2018
, “
Synovial and Systemic Pharmacokinetics (PK) of Triamcinolone Acetonide (TA) Following Intra-Articular (IA) Injection of an Extended-Release Microsphere-Based Formulation (FX006) or Standard Crystalline Suspension in Patients With Knee Osteoarthritis (OA)
,”
Osteoarthr. Cartil.
,
26
, pp.
34
42
.10.1016/j.joca.2017.10.003
19.
Sabaratnam
,
S.
,
Arunan
,
V.
,
Coleman
,
P. J.
,
Mason
,
R. M.
, and
Levick
,
J. R.
,
2005
, “
Size Selectivity of Hyaluronan Molecular Sieving by Extracellular Matrix in Rabbit Synovial Joints
,”
J. Physiol.
,
567
(
2
), pp.
569
581
.10.1113/jphysiol.2005.088906
20.
Levick
,
J. R.
,
1984
, “
An Analysis of the Effect of Synovial Capillary Distribution Upon Trans-Synovial Concentration Profiles and Exchange
,”
Q. J. Exp. Physiol.
,
69
(
2
), pp.
289
300
.10.1113/expphysiol.1984.sp002806
21.
Levick
,
J. R.
, and
McDonald
,
J. N.
,
1995
, “
Fluid Movement Across Synovium in Healthy Joints: Role of Synovial Fluid Macromolecules
,”
Ann. Rheum. Dis.
,
54
(
5
), pp.
417
423
.10.1136/ard.54.5.417
22.
Castor
,
C. W.
,
1960
, “
The Microscopic Structure of Normal Human Synovial Tissue
,”
Arthritis Rheum.
,
3
(
2
), pp.
140
151
.10.1002/art.1780030205
23.
Smith
,
M. D.
,
2011
, “
The Normal Synovium
,”
Open Rheumatol. J.
,
5
, pp.
100
106
.10.2174/1874312901105010100
24.
Barland
,
P.
,
Novikoff
,
A. B.
, and
Hamerman
,
D.
,
1962
, “
Electron Microscopy of the Human Synovial Membrane
,”
J. Cell Biol.
,
14
(
2
), pp.
207
220
.10.1083/jcb.14.2.207
25.
Simkin
,
P. A.
, and
Pizzorno
,
J. E.
,
1974
, “
Transynovial Exchange of Small Molecules in Normal Human Subjects
,”
J. Appl. Physiol.
,
36
(
5
), pp.
581
587
.10.1152/jappl.1974.36.5.581
26.
Simkin
,
P. A.
,
1995
, “
Synovial Perfusion and Synovial Fluid Solutes
,”
Ann. Rheum. Dis.
,
54
(
5
), pp.
424
428
.10.1136/ard.54.5.424
27.
Blewis
,
M. E.
,
Lao
,
B. J.
,
Schumacher
,
B. L.
,
Bugbee
,
W. D.
,
Sah
,
R. L.
, and
Firestein
,
G. S.
,
2010
, “
Interactive Cytokine Regulation of Synoviocyte Lubricant Secretion
,”
Tissue Eng. Part A
,
16
(
4
), pp.
1329
1337
.10.1089/ten.tea.2009.0210
28.
Price
,
F. M.
,
Levick
,
J. R.
, and
Mason
,
R. M.
,
1996
, “
Glycosaminoglycan Concentration in Synovium and Other Tissues of Rabbit Knee in Relation to Synovial Hydraulic Resistance
,”
J. Physiol.
,
495
(
3
), pp.
803
820
.10.1113/jphysiol.1996.sp021634
29.
Bhattaram
,
P.
, and
Chandrasekharan
,
U.
,
2017
, “
The Joint Synovium: A Critical Determinant of Articular Cartilage Fate in Inflammatory Joint Diseases
,”
Semin. Cell Dev. Biol.
,
62
, pp.
86
93
.10.1016/j.semcdb.2016.05.009
30.
Blewis
,
M. E.
,
Lao
,
B. J.
,
Jadin
,
K. D.
,
McCarty
,
W. J.
,
Bugbee
,
W. D.
,
Firestein
,
G. S.
,
Sah
,
R. L.
, and
Bioeng
,
B.
,
2010
, “
Semi-Permeable Membrane Retention of Synovial Fluid Lubricants Hyaluronan and Proteoglycan 4 for a Biomimetic Bioreactor NIH Public Access Author Manuscript
,”
Biotechnol. Bioeng.
,
106
(
1
), pp.
149
160
.10.1002/bit.22645
31.
Stefani
,
R. M.
,
Halder
,
S. S.
,
Estell
,
E. G.
,
Lee
,
A. J.
,
Silverstein
,
A. M.
,
Sobczak
,
E.
,
Chahine
,
N. O.
,
Ateshian
,
G. A.
,
Shah
,
R. P.
, and
Hung
,
C. T.
,
2019
, “
A Functional Tissue Engineered Synovium Model to Study Osteoarthritis Progression and Treatment
,”
Tissue Eng. Part A
,
25
(7–8), p. 538.10.1089/ten.TEA.2018.0142.
32.
Blasioli
,
D. J.
,
Matthews
,
G. L.
, and
Kaplan
,
D. L.
,
2014
, “
The Degradation of Chondrogenic Pellets Using Cocultures of Synovial Fibroblasts and U937 Cells
,”
Biomaterials
,
35
(
4
), pp.
1185
1191
.10.1016/j.biomaterials.2013.10.050
33.
Sterner
,
B.
,
Harms
,
M.
,
Wöll
,
S.
,
Weigandt
,
M.
,
Windbergs
,
M.
, and
Lehr
,
C. M.
,
2016
, “
The Effect of Polymer Size and Charge of Molecules on Permeation Through Synovial Membrane and Accumulation in Hyaline Articular Cartilage
,”
Eur. J. Pharm. Biopharm.
,
101
, pp.
126
136
.10.1016/j.ejpb.2016.02.004
34.
Zhu
,
Q.
,
Jackson
,
A. R.
, and
Gu
,
W. Y.
,
2012
, “
Cell Viability in Intervertebral Disc Under Various Nutritional and Dynamic Loading Conditions: 3D Finite Element Analysis
,”
J. Biomech.
,
45
(
16
), pp.
2769
2777
.10.1016/j.jbiomech.2012.08.044
35.
Jackson
,
A. R.
,
Huang
,
C.-Y. C.
,
Brown
,
M. D.
, and
Yong Gu
,
W.
,
2011
, “
3D Finite Element Analysis of Nutrient Distributions and Cell Viability in the Intervertebral Disc: Effects of Deformation and Degeneration
,”
ASME J. Biomech. Eng.
,
133
(
9
), p.
091006
.10.1115/1.4004944
36.
Mauck
,
R. L.
,
Hung
,
C. T.
, and
Ateshian
,
G. A.
,
2003
, “
Modeling of Neutral Solute Transport in a Dynamically Loaded Porous Permeable Gel: Implications for Articular Cartilage Biosynthesis and Tissue Engineering
,”
ASME J. Biomech. Eng.
,
125
(
5
), pp.
602
614
.10.1115/1.1611512
37.
Ateshian
,
G. A.
,
Chahine
,
N. O.
,
Basalo
,
I. M.
, and
Hung
,
C. T.
,
2004
, “
The Correspondence Between Equilibrium Biphasic and Triphasic Material Properties in Mixture Models of Articular Cartilage
,”
J. Biomech.
,
37
(
3
), pp.
391
400
.10.1016/S0021-9290(03)00252-5
38.
Lees
,
S.
, and
Heeley
,
J. D.
,
1981
, “
Density of a Sample Bovine Cortical Bone Matrix and Its Solid Constituent in Various Media
,”
Calcif. Tissue Int.
,
33
(
1
), pp.
499
504
.10.1007/BF02409480
39.
Gu
,
W. Y.
,
Lai
,
W. M.
, and
Mow
,
V. C.
,
1998
, “
A Mixture Theory for Charged-Hydrated Soft Tissues Containing Multi-Electrolytes: Passive Transport and Swelling Behaviors
,”
ASME J. Biomech. Eng.
,
120
(
2
), pp.
169
180
.10.1115/1.2798299
40.
Lai
,
W. M.
,
Hou
,
J. S.
, and
Mow
,
V. C.
,
1991
, “
A Triphasic Theory for the Swelling and Deformation Behaviors of Articular Cartilage
,”
ASME J. Biomech. Eng.
,
113
(
3
), p.
245
.10.1115/1.2894880
41.
Maas
,
S. A.
,
Ellis
,
B. J.
,
Ateshian
,
G. A.
, and
Weiss
,
J. A.
,
2012
, “
FEBio: Finite Elements for Biomechanics
,”
ASME J. Biomech. Eng.
,
134
(
1
), p.
011005
.10.1115/1.4005694
42.
Ateshian
,
G. A.
,
Maas
,
S.
, and
Weiss
,
J. A.
,
2013
, “
Multiphasic Finite Element Framework for Modeling Hydrated Mixtures With Multiple Neutral and Charged Solutes
,”
ASME J. Biomech. Eng.
,
135
(
11
), p.
111001
.10.1115/1.4024823
43.
Leaist
,
D. G.
, and
Hao
,
L.
,
1994
, “
Simultaneous Measurement of Mutual Diffusion and Intradiffusion by Taylor Dispersion
,”
J. Phys. Chem.
,
98
(
17
), pp.
4702
4706
.10.1021/j100068a035
44.
Arbabi
,
V.
,
Pouran
,
B.
,
Weinans
,
H.
, and
Zadpoor
,
A. A.
,
2015
, “
Transport of Neutral Solute Across Articular Cartilage: The Role of Zonal Diffusivities
,”
ASME J. Biomech. Eng.
,
137
(
7
), p.
071001
.10.1115/1.4030070
45.
Nims
,
R. J.
,
Cigan
,
A. D.
,
Albro
,
M. B.
,
Vunjak-Novakovic
,
G.
,
Hung
,
C. T.
, and
Ateshian
,
G. A.
,
2015
, “
Matrix Production in Large Engineered Cartilage Constructs Is Enhanced by Nutrient Channels and Excess Media Supply
,”
Tissue Eng. Part C Methods
,
21
(
7
), pp.
747
757
.10.1089/ten.tec.2014.0451
46.
Levick
,
J. R.
,
1987
, “
Synovial Fluid and Trans-Synovial Flow in Stationary and Moving Normal Joints
,”
Joint Loading-Biology and Health of Articular Structures
,
H. J.
Helminen
,
I.
Kiviranta
,
M.
Tammi
,
A. M.
Säämänen
, and
H.
Helminen
, eds.,
Butterworth-Heinemann Ltd
, Oxford, UK, pp.
149
186
.
47.
Moré
,
J. J.
,
1977
, “
The Levenberg-Marquardt Algorithm: Implementation and Theory
,”
Numerical Analysis
(Lecture Notes in Mathematics), Vol.
630
,
G. A.
Watson
, ed.,
Springer Verlag
, Berlin, Germany.
48.
Arbabi
,
V.
,
Pouran
,
B.
,
Weinans
,
H.
, and
Zadpoor
,
A. A.
,
2016
, “
Multiphasic Modeling of Charged Solute Transport Across Articular Cartilage: Application of Multi-Zone Finite-Bath Model
,”
J. Biomech.
,
49
(
9
), pp.
1510
1517
.10.1016/j.jbiomech.2016.03.024
49.
DiDomenico
,
C. D.
,
Goodearl
,
A.
,
Yarilina
,
A.
,
Sun
,
V.
,
Mitra
,
S.
,
Sterman
,
A. S.
, and
Bonassar
,
L. J.
,
2017
, “
The Effect of Antibody Size and Mechanical Loading on Solute Diffusion Through the Articular Surface of Cartilage
,”
ASME J. Biomech. Eng.
,
139
(
9
), p.
091005
.10.1115/1.4037202
50.
DiDomenico
,
C. D.
,
Xiang Wang
,
Z.
, and
Bonassar
,
L. J.
,
2017
, “
Cyclic Mechanical Loading Enhances Transport of Antibodies Into Articular Cartilage
,”
ASME J. Biomech. Eng.
,
139
(
1
), p.
011012
.10.1115/1.4035265
51.
Albro
,
M. B.
,
Nims
,
R. J.
,
Durney
,
K. M.
,
Cigan
,
A. D.
,
Shim
,
J. J.
,
Vunjak-Novakovic
,
G.
,
Hung
,
C. T.
, and
Ateshian
,
G. A.
,
2016
, “
Heterogeneous Engineered Cartilage Growth Results From Gradients of Media-Supplemented Active TGF-β and Is Ameliorated by the Alternative Supplementation of Latent TGF-β
,”
Biomaterials
,
77
, pp.
173
185
.10.1016/j.biomaterials.2015.10.018
52.
Wigginton
,
S. M.
,
Chu
,
B. C. F.
,
Weisman
,
M. H.
, and
Howell
,
S. B.
,
1980
, “
Methotrexate Pharmacokinetics After Intraarticular Injection in Patients With Rheumatoid Arthritis
,”
Arthritis Rheum.
,
23
(
1
), pp.
119
122
.10.1002/art.1780230121
53.
Soma
,
L. R.
,
Uboh
,
C. E.
,
Luo
,
Y.
,
Guan
,
F.
,
Moate
,
P. J.
, and
Boston
,
R. C.
,
2006
, “
Pharmacokinetics of Methylprednisolone Acetate After Intra-Articular Administration and Its Effect on Endogenous Hydrocortisone and Cortisone Secretion in Horses
,”
Am. J. Vet. Res.
,
67
(
4
), pp.
654
662
.10.2460/ajvr.67.4.654
54.
Owen
,
S.
,
Francis
,
H.
, and
Roberts
,
M.
,
1994
, “
Disappearance Kinetics of Solutes From Synovial Fluid After Intra- Articular Injection
,”
Br. J. Clin. Pharmacol.
,
38
(
4
), pp.
349
355
.10.1111/j.1365-2125.1994.tb04365.x
55.
Knight
,
A. D.
, and
Levick
,
J. R.
,
1983
, “
The Density and Distribution of Capillaries Around a Synovial Cavity
,”
Q. J. Exp. Physiol.
,
68
(
4
), pp.
629
644
.10.1113/expphysiol.1983.sp002753
56.
Larsen
,
S. W.
,
Frost
,
A. B.
,
Østergaard
,
J.
,
Thomsen
,
M. H.
,
Jacobsen
,
S.
,
Skonberg
,
C.
,
Hansen
,
S. H.
,
Jensen
,
H. E.
, and
Larsen
,
C.
,
2011
, “
In Vitro and In Vivo Characteristics of Celecoxib In Situ Formed Suspensions for Intra-Articular Administration
,”
J. Pharm. Sci.
,
100
(
10
), pp.
4330
4337
.10.1002/jps.22630
57.
Betre
,
H.
,
Liu
,
W.
,
Zalutsky
,
M. R.
,
Chilkoti
,
A.
,
Kraus
,
V. B.
, and
Setton
,
L. A.
,
2006
, “
A Thermally Responsive Biopolymer for Intra-Articular Drug Delivery
,”
J. Control Release
,
115
(
2
), pp.
175
182
.10.1016/j.jconrel.2006.07.022
58.
Tunçay
,
M.
,
Çaliş
,
S.
,
Kaş
,
H.
,
Ercan
,
M.
,
Peksoy
,
I.
, and
Hincal
,
A.
,
2000
, “
Diclofenac Sodium Incorporated PLGA (50:50) Microspheres: Formulation Considerations and In Vitro/In Vivo Evaluation
,”
Int. J. Pharm.
,
195
(
1–2
), pp.
179
188
.10.1016/S0378-5173(99)00394-4
59.
Horisawa
,
E.
,
Kubota
,
K.
,
Tuboi
,
I.
,
Sato
,
K.
,
Yamamoto
,
H.
,
Takeuchi
,
H.
, and
Kawashima
,
Y.
,
2002
, “
Size-Dependency of DL-Lactide/Glycolide Copolymer Particulates for Intra-Articular Delivery System on Phagocytosis in Rat Synovium
,”
Pharm. Res.
,
19
(
2
), pp.
132
139
.10.1023/A:1014260513728
60.
Shibakawa
,
A.
,
Aoki
,
H.
,
Masuko-Hongo
,
K.
,
Kato
,
T.
,
Tanaka
,
M.
,
Nishioka
,
K.
, and
Nakamura
,
H.
,
2003
, “
Presence of Pannus-Like Tissue on Osteoarthritic Cartilage and Its Histological Character
,”
Osteoarthr. Cartil.
,
11
(
2
), pp.
133
140
.10.1053/joca.2002.0871
61.
Levick
,
J. R.
, and
Michel
,
C. C.
,
2010
, “
Microvascular Fluid Exchange and the Revised Starling Principle
,”
Cardiovasc. Res.
,
87
(
2
), pp.
198
210
.10.1093/cvr/cvq062
62.
Zhou
,
Q.
,
Guo
,
R.
,
Wood
,
R.
,
Boyce
,
B. F.
,
Liang
,
Q.
,
Wang
,
Y.-J.
,
Schwarz
,
E. M.
, and
Xing
,
L.
,
2011
, “
Vascular Endothelial Growth Factor C Attenuates Joint Damage in Chronic Inflammatory Arthritis by Accelerating Local Lymphatic Drainage in Mice
,”
Arthritis Rheum.
,
63
(
8
), pp.
2318
2328
.10.1002/art.30421
63.
Bouta
,
E. M.
,
Li
,
J.
,
Ju
,
Y.
,
Brown
,
E. B.
,
Ritchlin
,
C. T.
,
Xing
,
L.
, and
Schwarz
,
E. M.
,
2015
, “
The Role of the Lymphatic System in Inflammatory-Erosive Arthritis
,”
Semin. Cell Dev. Biol.
,
38
, pp.
90
97
.10.1016/j.semcdb.2015.01.001
64.
Scott
,
D.
,
Coleman
,
P. J.
,
Mason
,
R. M.
, and
Levick
,
J. R.
,
2000
, “
Action of Polysaccharides of Similar Average Mass but Differing Molecular Volume and Charge on Fluid Drainage Through Synovial Interstitium in Rabbit Knees
,”
J. Physiol.
,
528
(
3
), pp.
609
618
.10.1111/j.1469-7793.2000.00609.x
65.
Jackson
,
A. R.
,
Yuan
,
T.-Y.
,
Huang
,
C.-Y. C.
,
Travascio
,
F.
, and
Yong Gu
,
W.
,
2008
, “
Effect of Compression and Anisotropy on the Diffusion of Glucose in Annulus Fibrosus
,”
Spine
,
33
(
1
), pp.
1
7
.10.1097/BRS.0b013e31815e4136
66.
Albro
,
M. B.
,
Rajan
,
V.
,
Li
,
R.
,
Hung
,
C. T.
, and
Ateshian
,
G. A.
,
2009
, “
Characterization of the Concentration-Dependence of Solute Diffusivity and Partitioning in a Model Dextran-Agarose Transport System
,”
Cell. Mol. Bioeng.
,
2
(
3
), pp.
295
305
.10.1007/s12195-009-0076-4
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