Joint kinematic instability, arising from congenital or acquired musculoskeletal pathoanatomy or from imbalances in anabolism and catabolism induced by pathophysiological factors, leads to deterioration of the composition, structure and function of cartilage and, ultimately, progression to osteoarthritis (OA). Alongside articular cartilage degeneration, synovial fluid lubricity decreases in OA owing to a reduction in the concentration and molecular weight of hyaluronic acid and surface-active mucinous glycoproteins that form a lubricating film over the articulating joint surfaces. Minimizing friction between articulating joint surfaces by lubrication is fundamental for decreasing hyaline cartilage wear and for maintaining the function of synovial joints. Augmentation with highly viscous supplements (that is, viscosupplementation) offers one approach to re-establishing the rheological and tribological properties of synovial fluid in OA. However, this approach has varied clinical outcomes owing to limited intra-articular residence time and ineffective mechanisms of chondroprotection. This Review discusses normal hyaline cartilage function and lubrication and examines the advantages and disadvantages of various strategies for restoring normal joint lubrication. These strategies include contemporary viscosupplements that contain antioxidants, anti-inflammatory drugs or platelet-rich plasma and new synthetic synovial fluid additives and cartilage matrix enhancers. Advanced biomimetic tribosupplements offer promise for mitigating cartilage wear, restoring joint function and, ultimately, improving patient care.

由先天性或后天性肌肉骨骼病理解剖学或病理生理因素引起的合成代谢和分解代谢失衡引起的关节运动不稳定，导致软骨的组成、结构和功能恶化，并最终进展为骨关节炎（OA）。除了关节软骨退化之外，OA 中的滑液润滑性也会降低，这是由于透明质酸和表面活性粘液糖蛋白的浓度和分子量降低，这些糖蛋白在关节表面形成润滑膜。通过润滑最大限度地减少关节表面之间的摩擦是减少透明软骨磨损和维持滑膜关节功能的基础。使用高粘性补充剂（即粘性补充剂）进行增强治疗提供了一种重建 OA 滑液流变学和摩擦学特性的方法。然而，由于关节内停留时间有限和软骨保护机制无效，这种方法的临床结果各不相同。本综述讨论了正常透明软骨的功能和润滑，并探讨了恢复正常关节润滑的各种策略的优缺点。这些策略包括含有抗氧化剂、抗炎药或富含血小板的血浆的现代粘稠补充剂以及新型合成滑液添加剂和软骨基质增强剂。先进的仿生摩擦补充剂有望减轻软骨磨损、恢复关节功能并最终改善患者护理。