Does cartilage compliance reduce skeletal impact loads?. the relative force‐attenuating properties of articular cartilage, synovial fluid, periarticular soft tissues and bone
TL;DR: The contention that the integrity of bone could well be important in prolonging joint life is supported, as the ability of synovial fluid, supporting bone and periarticular soft tissues to provide this compliance and attenuate peak forces might spare the articular cartilage and prevent wear.
Abstract: Joint wear is related to the pressure exerted at the articular cartilage interface. The largest loads an animal joint experiences in life will be brief and will result from impact. Compliance in the system will decrease the peak value of such impulsive loadings at the expense, probably unimportant, of increasing their duration. The ability of synovial fluid, supporting bone and periarticular soft tissues to provide this compliance and attenuate peak forces might spare the articular cartilage and prevent wear. Measurements were made of the relative attenuation of longitudinally applied, external impulsive force by these major joint elements of adult bovine interphalangeal joints. The effect of the various elements, independently, upon the over-all compliance of the joint was measured in nonimpulsive experiments and found to correlate quite well with their ability to reduce the peak load in the impulsive experiments. Only the periarticular soft tissues (capsule, ligaments and synovial tissue) and bone have significant force-attenuating properties. Articular cartilage and synovial fluid have little effect. These results support the contention that the integrity of bone could well be important in prolonging joint life.
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TL;DR: Ooarthritis is viewed as an attempt to contain a mechanical problem in the joint and as failed repair of damage caused by excessive mechanical stress on the joint, and it is unlikely that a drug that inhibits a specific enzyme or cytokine in the pathways of cartilage breakdown, or further stimulates the already increased synthesis ofcartilage matrix molecules will solve the problem of OA.
667 citations
TL;DR: The knee joints of adult rabbits were subjected to daily one hour intervals of impulsive loading equivalent to their body weight at 60 cpm and developed changes in their knee joints consistent with those of degenerative joint disease.
616 citations
TL;DR: Reduced quadriceps strength relative to body weight may be a risk factor for knee OA in women, and a strong positive correlation with body weight is seen.
Abstract: Objective
To determine whether baseline lower extremity muscle weakness is a risk factor for incident radiographic osteoarthritis (OA) of the knee.
Methods
This prospective study involved 342 elderly community-dwelling subjects (178 women, 164 men) from central Indiana, for whom baseline and followup (mean interval 31.3 months) knee radiographs were available. Lower extremity muscle strength was measured by isokinetic dynamometry and lean tissue (i.e., muscle) mass in the lower extremities by dual x-ray absorptiometry.
Results
Knee OA was associated with an increase in body weight in women (P = 0.0014), but not in men. In both sexes, lower extremity muscle mass exhibited a strong positive correlation with body weight. In women, after adjustment for body weight, knee extensor strength was 18% lower at baseline among subjects who developed incident knee OA than among the controls (P = 0.053), whereas after adjustment for lower extremity muscle mass, knee extensor strength was 15% lower than in the controls (P not significant). In men, in contrast, adjusted knee extensor strength at baseline was comparable to that in the controls. Among the 13 women who developed incident OA, there was a strong, highly significant negative correlation between body weight and extensor strength (r = -0.740, P = 0.003), that is, the more obese the subject, the greater the reduction of quadriceps strength. In contrast, among the 14 men who developed incident OA, a modest positive correlation existed between weight and quadriceps strength (r = 0.455, P = 0.058). No correlation between knee flexor (hamstring) strength and knee OA was seen in either sex.
Conclusion
Reduced quadriceps strength relative to body weight may be a risk factor for knee OA in women.
583 citations
TL;DR: This work suggests that joints can wear out by repetitive impulsive loading, rather than by rubbing, and proposes a new mechanistic approach compatible with the pathology of and clinical experience with the disease.
564 citations
TL;DR: A profound understanding of the basic anatomic aspects of this particular site, together with the pathophysiology of diseases affecting the subchondral bone is the key to develop targeted and effective therapeutic strategies to treat osteochondral defects.
Abstract: In the past decades, considerable efforts have been made to propose experimental and clinical treatments for articular cartilage defects. Yet, the problem of cartilage defects extending deep in the underlying subchondral bone has not received adequate attention. A profound understanding of the basic anatomic aspects of this particular site, together with the pathophysiology of diseases affecting the subchondral bone is the key to develop targeted and effective therapeutic strategies to treat osteochondral defects. The subchondral bone consists of the subchondral bone plate and the subarticular spongiosa. It is separated by the cement line from the calcified zone of the articular cartilage. A variable anatomy is characteristic for the subchondral region, reflected in differences in thickness, density, and composition of the subchondral bone plate, contour of the tidemark and cement line, and the number and types of channels penetrating into the calcified cartilage. This review aims at providing insights into the anatomy, morphology, and pathology of the subchondral bone. Individual diseases affecting the subchondral bone, such as traumatic osteochondral defects, osteochondritis dissecans, osteonecrosis, and osteoarthritis are also discussed. A better knowledge of the basic science of the subchondral region, together with additional investigations in animal models and patients may translate into improved therapies for articular cartilage defects that arise from or extend into the subchondral bone.
487 citations
Cites background from "Does cartilage compliance reduce sk..."
...Its contribution to impulsive load attenuation [87, 88] and to endoprosthesis support [83] is well documented....
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References
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680 citations
TL;DR: In order to assess, in such cases of so-called primary osteoarthritis, the presence of any minor pre-existing anatomical abnormality, the pelvic radiographs of 200 cases of this type were examined.
Abstract: In most reports on osteoarthritis of the hip approximately half the patients have presented in adult life with no relevant antecedent history. In order to assess, in such cases of so-called primary osteoarthritis, the presence of any minor pre-existing anatomical abnormality, the pelvic radiographs of 200 cases of this type were examined. No case in which the changes could be attributed to symptomatic disorder earlier in life was accepted. In this connection a few cases showing a protrusio acetabuli deformity were arbitrarily regarded as being secondary to inflammatory change of a rheumatoid nature and were therefore excluded. The cases were divided by visual assessment into those arising in the presence of (a) normal anatomy; (b) abnormal anatomy. The variations in the latter group included imperfect acetabular development—acetabular dysplasia—and an abnormal relationship of the femoral head to the femoral neck, comparable to the residual adult deformity of epiphysiolysis in adolescence. This abnormality...
578 citations
TL;DR: In this paper, the factors affecting the determination of the physical properties of the femoral Cortical bone were discussed, and the authors proposed a method to determine the physical property of femoral cortical bone.
Abstract: (1966). Factors Affecting the Determination of the Physical Properties of Femoral Cortical Bone. Acta Orthopaedica Scandinavica: Vol. 37, No. 1, pp. 29-48.
577 citations
TL;DR: A series of friction experiments were performed which provide confirmation that animal joints are weeping bearings and confirm that synovial fluid is an excellent lubricant for cartilage.
575 citations
TL;DR: It is highly likely, from the evidence presented, that alterations in the quality of the subchondral bone could have a profound effect on the ability of a subchONDral bone-articular cartilage system to withstand compressive dynamic forces.
Abstract: Compression tests on plugs of bovine articular cartilage and of subchondral bone demonstrated that both are capable of deforming under pressure and thus attenuating peak dynamic forces applied to the plugs. Although cancellous bone is approximately ten times stiffer than articular cartilage per unit of thickness, subchondral bone in vivo is considerably thicker and would, therefore, seem capable of contributing to dynamic force attenuation as much as the cartilage does or more. Under physiological loads and loading rates, a film of synovial fluid on the cartilage added nothing to the ability of cartilage plugs to attenuate peak dynamic force; however, at very low load rates cartilage plugs coated with synovial fluid were consistently stiffer than specimens coated with veronate buffer. It is highly likely, from the evidence presented, that alterations in the quality of the subchondral bone could have a profound effect on the ability of a subchondral bone-articular cartilage system to withstand compressive dynamic forces.
238 citations