{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T13:48:47Z","timestamp":1775742527651,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T00:00:00Z","timestamp":1146096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Hyaluronan (HA) has a major role in regulating synovial fluid volume. This role depends on the synovium functioning as an ultrafilter that reflects HA during trans\u2013synovial fluid drainage. Reflection boosts the HA concentration on the membrane surface, leading to osmotic retention of synovial fluid (\u201cbuffering\u201d). In arthritic effusions, however, HA concentration and osmotic buffering are greatly reduced. We tested the hypothesis that reflection is reduced (escape increased) when the HA concentration falls below the molecular entanglement concentration (<jats:italic>C<\/jats:italic>*).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HA at 0.2 mg\/ml (&lt;<jats:italic>C<\/jats:italic>*) or 1.5 mg\/ml (&gt;<jats:italic>C<\/jats:italic>*) was infused continuously into rabbit knee joints to set up a steady trans\u2010synovial filtration. Joint\u2010derived lymph was sampled over 3 hours, and subsynovial fluid was sampled at the end of the 3\u2010hour period. HA was quantified by high\u2010performance liquid chromatography to evaluate the reflected fraction. <jats:italic>C<\/jats:italic>* was determined by viscometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Viscometry showed that 0.2 mg\/ml HA was below <jats:italic>C<\/jats:italic>* and 1.5 mg\/ml was above it. At 0.2 mg\/ml, the mean \u00b1 SEM HA reflected fraction was 0.66 \u00b1 0.04 (n = 7). At 1.5 mg\/ml the reflection increased to 0.88 \u00b1 0.04 (n = 5) (<jats:italic>P<\/jats:italic> &lt; 0.005). HA permeation increased almost 3\u2010fold, from 12% to 34%, at the lower concentration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Chain\u2013chain interaction at &gt;<jats:italic>C<\/jats:italic>* increases effective molecular domain size and hence HA reflection, promoting effective conservation of synovial fluid in normal joints. HA can fall below <jats:italic>C<\/jats:italic>* (\u223c1 mg\/ml) in arthritic effusions, promoting loss of HA. The attendant failure of outflow buffering facilitates fluid escape and periarticular edema.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.21803","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T20:23:55Z","timestamp":1146169435000},"page":"1673-1681","source":"Crossref","is-referenced-by-count":3,"title":["Hyaluronan molecular reflection by synovial lining is concentration dependent and reduced in dilute effusions in a rabbit model"],"prefix":"10.1002","volume":"54","author":[{"given":"S.","family":"Sabaratnam","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. M.","family":"Mason","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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