Ultrastructure of transport pathways in stressed synovium of the knee in anaesthetized rabbits.

1. The hydraulic conductance of the synovial lining of a rabbit knee increases greatly when intra-articular pressure (IAP) is raised above approximately 9 cmH2O (yield point). To investigate the cause, synovium was fixed in situ by perfusion at controlled IAP and prepared for transmission electron microscopy. Micrographs of synovium fixed below yield pressure (atmospheric pressure and 5 cmH2O IAP, ten joints) and above it (25 cmH2O IAP, five joints) were analysed by morphometry. 2. The discontinuous cellular lining consisted of fibroblast-like cells (67%) and macrophage-like cells (33%) separated by interstitium-filled gaps. Interstitium formed 26-36% of the surface below yield pressure. Depending on sample site the surface gaps averaged 1.9 +/- 0.2 to 2.4 +/- 0.2 microns wide below yield pressure (mean +/- S.E.M. throughout). Above yield pressure the mean gap width increased by 42-64% (P less than 0.05, analysis of variance). 3. The qualitative and quantitative composition of the lining varied with distance below the surface. In a plane 5 microns deep, the intercellular distances and interstitial area fraction were almost double those at the surface. Classic periodic collagen fibrils (diameter 50 +/- 3 nm) abounded at 5 microns depth whereas the surface interstitium was richer in Ruthenium Red-staining microfibrils (diameter 9.3 +/- 0.7 nm) associated with 93 nm period fibrous long-spacing bundles. 4. Averaging over all the tissue between the surface and the 5 microns deep plane, the mean interstitial volume fraction was 0.61 +/- 0.05 at 5 cmH2O and 0.67 +/- 0.02 at 25 cmH2O (n.s.). 5. Capillary fenestrae (8.5 +/- 1.1 per fenestrated profile) and intercellular junctions were unaltered at high IAP. The tortuosity of the capillary-to-joint cavity path was 1.50 +/- 0.01 below yield pressure and 1.86 +/- 0.24 at 25 cmH2O (n.s.). 6. Intra-articular tracers (ferrocyanide, ferritin and glycogen) permeated synovial interstitium without evidence of preferential pathways. Ferrocyanide delineated the capillary intercellular junction as a permeable channel. Ferritin and glycogen were phagocytosed by the macrophages. 7. In suprapatellar areolar synovium, the most extensive and most altered tissue, the ratio of interstitial area to path length increased maximally 4.1 times between 5 and 25 cmH2O IAP. This represents a substantial contribution to the physiologically estimated rise in interstitial conductance (14 x) but does not wholly explain it.