Quantitative determination of joint incongruity and pressure distribution during simulated gait and cartilage thickness in the human hip joint

Abstract

The objective of this study was to provide quantitative data on hip-joint incongruity and pressure during a simulated walking cycle and on articular-cartilage thickness in the same set of specimens. Using a casting technique in eigth specimens of the human hip (age: 18-75 years), we determined the width of the joint space (incongruity) required at minimal load for contact at four phases of the gait cycle. The pressure distribution, measured with pressure-sensitive film, was determined at physiologic load magnituded on the basis of in vivo measurements of hip-joint forces. Cartilage thickness was assessed with A-mode ultrasound. At minimal loading, the average maximum width of the joint space ranged from 1.1 to 1.5 mm in the acetabular roof, with the contact areas located ventro-superiorly and dorso-inferiorly throughout the gait cycle. At physiological loading, the width decreased and the contact areas covered the complete articular surface during midstance and heel-off but not during heel-strike or toe-off. The pressure distribution was inhomogeneous during all phases, with average maximum pressures of 7.7 ± 1.95 MPa at midstance. The cartilage thickness varied considerably throughout the joint surfaces; maxima greater than 3 mm were found ventro-superiorly. These data can be used to generate and validate computer models to determine the loadsharing between the interstitial fluid and the solid proteoglycan-collagen matrix of articular cartilage, the latter being relevant for the initiation of mechanically induced cartilage degeneration.