Improved techniques for measuring in vitro the geometry and pressure distribution in the human acetabulum—I. Ultrasonic measurement of acetabular surfaces, sphericity and cartilage thickness

doi:10.1016/0021-9290(81)90070-1

Journal of Biomechanics

Volume 14, Issue 4, 1981, Pages 253-255, 257-260

https://doi.org/10.1016/0021-9290(81)90070-1 Get rights and content

Abstract

A unique, highly accurate, non-contacting method for measuring the loaded and unloaded shape and thickness of acetabular articular cartilage employing ultrasound is described. The unloaded cartilage surface is shown to be spherical with localized deviations less than 150 μm. The calcified cartilage interface is quite irregular with deviations from sphericity of 500 μm. The centers of the best-fitting spheres to the cartilage surface and the calcified interface are displaced resulting in decreased cartilage thickness in the anterior medial aspect.

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The central frequency of the ultrasound wave was 10 MHz. As the wave passes through interfaces between media of different acoustic impedances, reflections return to the transducer and generate electrical signals in the transducer that are proportional to the intensity.22 The validation study for this method was reported by Mori et al.21 Fig 2 presents the scene of measurement of cartilage mechanical properties using an arthroscopic ultrasonic probe; the probe was placed perpendicular to the measured cartilage surface because we could change the angle of the tip of its probe at 5 grades from 0° to 90°.
The purpose of this study was to determine the clinical and chondroprotective efficacy and safety of orally administered Theracurmin in patients who underwent mosaicplasty for knee chondral or osteochondral diseases over 12 months of treatment.
We enrolled 50 patients, older than 20 years of age, who underwent mosaicplasty for their knee joint diseases. Theracurmin at 180 mg of curcumin per day or placebo was administered orally every day for 12 months. Because 7 patients dropped out of the study, 43 patients were examined; they included 14 men and 29 women and 24 right and 19 left knees. The mean operative age was 59.5 years (range, 24-84 years). We evaluated the Japanese Orthopaedic Association knee osteoarthritis score (JOA), visual analog scale (VAS), and Japanese Knee Osteoarthritis Measure (JKOM) as clinical symptoms; T2 mapping values using magnetic resonance imaging as an indication of the chondroprotective effect; and blood concentration of curcumin at 0, 3, 6, and 12 months after the operations. We performed intraoperative acoustic evaluation of articular cartilage as a measure of chondroprotective effect during the operations and second-look arthroscopy.
The JOA, VAS and JKOM at 3, 6, and 12 months were significantly better than those during the preoperative period. However, the values of JOA, VAS and JKOM and T2 mapping were not significantly different between the Theracurmin and placebo groups. The blood concentration of curcumin in the Theracurmin group was significantly higher than that in the placebo group at 3, 6, and 12 months after the operations. Cartilage stiffness and surface roughness were significantly better in the Theracurmin group than in the placebo group at second-look arthroscopy.
The oral administration of Theracurmin for 1 year demonstrated significantly better chondroprotective effects and no worse clinical effects and adverse events than the placebo.
Level I, double-blinded, placebo-controlled, prospective study.
The influence of size, clearance, cartilage properties, thickness and hemiarthroplasty on the contact mechanics of the hip joint with biphasic layers
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The model utilized in the study was based on a standardized solid model of the pelvis and femur from a 38 year-old healthy human male at the time of death, available from the Internet through the BEL repository (Author: Vicceconti, from: www.tecno.ior.it/VRLAB/). The acetabulum and the femoral head surfaces were carefully trimmed spherically (Hammond and Charnley, 1967, Rushfeldt et al., 1981), and a layer of cartilage with uniform thickness was created from the spherical area. The resultant model approximated the native horseshoe shaped acetabular cartilage and the femoral head cartilage coverage (Fig. 1).
Computational models of the natural hip joint are needed to examine and optimise tissue sparing interventions where the natural cartilage remains part of the bearing surfaces. Although the importance of interstitial fluid pressurisation in the performance of cartilage has long been recognized, few studies have investigated the time dependent interstitial fluid pressurisation in a three dimensional natural hip joint model. The primary aim of this study was to develop a finite element model of the natural hip incorporating the biphasic cartilage layers that was capable of simulating the joint response over a prolonged physiological loading period. An initial set of sensitivity studies were also undertaken to investigate the influence of hip size, clearance, cartilage properties, thickness and hemiarthroplasty on the contact mechanics of the joint. The contact stress, contact area, fluid pressure and fluid support ratio were calculated and cross-compared between models with different parameters to evaluate their influence. It was found that the model predictions for the period soon after loading were sensitive to the hip size, clearance, cartilage aggregate modulus, thickness and hemiarthroplasty, while the time dependent behaviour over 3000 s was influenced by the hip clearance and cartilage aggregate modulus, permeability, thickness and hemiarthroplasty. The modelling methods developed in this study provide a basic platform for biphasic simulation of the whole hip joint onto which more sophisticated material models or other input parameters could be added in the future.
Application of near infrared (NIR) spectroscopy for determining the thickness of articular cartilage
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These methods are effective for laboratory and in vitro purposes, however, they are either destructive or cannot be easily adapted for real-time applications, e.g. during surgery. A-mode pulse-echo ultrasound [29,31,32] is a notable non-destructive technique that is often used for the determination cartilage thickness; however its accuracy is limited because of the difficulty involved in determining precisely the speed of the ultrasound wave in cartilage. This varies according to the pathological condition of the tissue [3].
The determination of the characteristics of articular cartilage such as thickness, stiffness and swelling, especially in the form that can facilitate real-time decisions and diagnostics is still a matter for research and development. This paper correlates near infrared spectroscopy with mechanically measured cartilage thickness to establish a fast, non-destructive, repeatable and precise protocol for determining this tissue property. Statistical correlation was conducted between the thickness of bovine cartilage specimens (n = 97) and regions of their near infrared spectra. Nine regions were established along the full absorption spectrum of each sample and were correlated with the thickness using partial least squares (PLS) regression multivariate analysis. The coefficient of determination (R²) varied between 53 and 93%, with the most predictive region (R² = 93.1%, p < 0.0001) for cartilage thickness lying in the region (wavenumber) 5350–8850 cm⁻¹. Our results demonstrate that the thickness of articular cartilage can be measured spectroscopically using NIR light. This protocol is potentially beneficial to clinical practice and surgical procedures in the treatment of joint disease such as osteoarthritis.
Fluid load support and contact mechanics of hemiarthroplasty in the natural hip joint
2011, Medical Engineering and Physics
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To understand the potential effect of hemiarthroplasty on the acetabular cartilage and improve prosthetic design, it is important to investigate the conditions under which the joint operates during different activities of daily living. Instrumented prostheses have been used to measure in vivo contact forces [2,7–10] and contact stresses [11–15] in both natural and artificial hip joints. Bergmann et al. have used instrumented prostheses to record the hip contact forces for nine activities [16].
The articular cartilage covering the ends of the bones of diarthrodial synovial joints is thought to have evolved so that the loads are transferred under different and complex conditions, with a very high degree of efficiency and without compromising the structural integrity of the tissue for the life of an individual. These loading conditions stem from different activities such as walking, and standing. The integrity of cartilage may however become compromised due to congenital disease, arthritis or trauma. Hemiarthroplasty is a potentially conservative treatment when only the femoral cartilage is affected as in case of femoral neck fractures. In hemiarthroplasty, a metallic femoral prosthesis is used to articulate against the natural acetabular cartilage. It has also been hypothesized that biphasic lubrication is the predominant mechanism protecting the cartilage through a very high fluid load support which lowers friction. This may be altered due to hemiarthroplasty and have a direct effect on the frictional shear stresses and potentially cartilage degradation and wear. This study modelled nine activities of daily living and investigated the contact mechanics of a hip joint with a hemiarthroplasty, focussing particularly on the role of the fluid phase.
It was shown that in most of the activities studied the peak contact stresses and peak fluid pressures were in the superior dome or lateral roof of the acetabulum. Total fluid load support was very high (∼90%) in most of the activities which would shield the solid phase from being subjected to very high contact stresses. This was dependent not only on the load magnitude but also the direction and hence on the location of the contact area with respect to the cartilage coverage. Lower fluid load support was found when the contact area was nearer the edges where the fluid drained easily.
Effects of idealized joint geometry on finite element predictions of cartilage contact stresses in the hip
2010, Journal of Biomechanics
Citation Excerpt :
However, it is unknown whether this degree of model fidelity is necessary. Investigators that have modeled the hip as a perfect ball and socket joint have argued that a spherical representation of the hip joint is appropriate (Genda et al., 1995, 2001; Yoshida et al., 2006) since anthropometric studies have demonstrated that the femoral head and acetabulum closely resemble a sphere (Rushfeldt et al., 1981; Macirowski et al., 1994; Menschik, 1997; Shepherd and Seedhom, 1999). However, geometrical similarity does not necessarily imply that models with idealized geometry will predict cartilage contact mechanics accurately.
Computational models may have the ability to quantify the relationship between hip morphology, cartilage mechanics and osteoarthritis. Most models have assumed the hip joint to be a perfect ball and socket joint and have neglected deformation at the bone-cartilage interface. The objective of this study was to analyze finite element (FE) models of hip cartilage mechanics with varying degrees of simplified geometry and a model with a rigid bone material assumption to elucidate the effects on predictions of cartilage stress. A previously validated subject-specific FE model of a cadaveric hip joint was used as the basis for the models. Geometry for the bone-cartilage interface was either: (1) subject-specific (i.e. irregular), (2) spherical, or (3) a rotational conchoid. Cartilage was assigned either a varying (irregular) or constant thickness (smoothed). Loading conditions simulated walking, stair-climbing and descending stairs. FE predictions of contact stress for the simplified models were compared with predictions from the subject-specific model. Both spheres and conchoids provided a good approximation of native hip joint geometry (average fitting error ∼0.5 mm). However, models with spherical/conchoid bone geometry and smoothed articulating cartilage surfaces grossly underestimated peak and average contact pressures (50% and 25% lower, respectively) and overestimated contact area when compared to the subject-specific FE model. Models incorporating subject-specific bone geometry with smoothed articulating cartilage also underestimated pressures and predicted evenly distributed patterns of contact. The model with rigid bones predicted much higher pressures than the subject-specific model with deformable bones. The results demonstrate that simplifications to the geometry of the bone-cartilage interface, cartilage surface and bone material properties can have a dramatic effect on the predicted magnitude and distribution of cartilage contact pressures in the hip joint.
A spectroscopic approach to imaging and quantification of cartilage lesions in human knee joints
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Journal of Biomechanics

Abstract

References (16)

In vitro measurement of articular cartilage deformations in the intact human hip joint under load

J. Bone Joint Surg.

Biochemical findings in normal and osteoarthritic articular cartilage II: Chondroitin sulfate concentration and chain length, water and ash content

J. Clin. Invest.

Primary osteoarthritis, venous engorgement and osteogenesis

J. Bone Joint Surg.

Incongruent surfaces in the human hip joint

Nature

A post mortem study of the hip joint

Ann. Rheu. Dis.

The shape of the normal femoral head and results from clinical use of more normally shaped nonspherical hip replacement prosthesis

J. Bone Joint Surg.

Human hip joint geometry and hemiarthroplasty selection

The sphericity of the femoral head

Med. Biol. Eng.

Cited by (91)

The Oral Administration of Highly-Bioavailable Curcumin for One Year Has Clinical and Chondro-Protective Effects: A Randomized, Double-Blinded, Placebo-Controlled Prospective Study

The influence of size, clearance, cartilage properties, thickness and hemiarthroplasty on the contact mechanics of the hip joint with biphasic layers

Application of near infrared (NIR) spectroscopy for determining the thickness of articular cartilage

Fluid load support and contact mechanics of hemiarthroplasty in the natural hip joint

Effects of idealized joint geometry on finite element predictions of cartilage contact stresses in the hip

A spectroscopic approach to imaging and quantification of cartilage lesions in human knee joints