Variations in thickness of articular cartilage in the human sacroiliac joint

Differences in articular cartilage thickness in the sacroiliac joint were investigated in different regions of the sacral and the iliac articular surfaces in the embalmed cadavers of five males and six females. The mean thickness of the sacral articular cartilage was greater than that of the iliac articular cartilage (P < 0.001) and the sacral articular cartilage of the female was thicker than that of the male (P < 0.02). Differences between thicknesses of the iliac articular cartilage in the male and female and in different regions of the sacral and iliac articular cartilages were found to be not significant.     

Biomechanical topography of human articular cartilage in the first metatarsophalangeal joint

The objective of this study was to provide a map of cartilage biomechanical properties, thickness, and histomorphometric characteristics in the human, cadaveric first metatarsophangeal joint, to determine if normal articular cartilage was predisposed topographically to biomechanical mismatches in articulating surfaces. Cartilage intrinsic material properties and thickness were obtained from seven pairs of human, freshly frozen, cadaveric, metatarsophalangeal joints using an automated creep indentation apparatus under conditions of biphasic creep. Eight sites were tested: four on the metatarsal head, two on the proximal phalanx base, and one on each sesamoid bone to obtain the aggregate modulus, Poisson's ratio, permeability, shear modulus, and thickness. Cartilage in the lateral phalanx site of the left metatarsal head had the largest aggregate modulus (1.34 MPa), whereas the softest tissue was found in the right medial sesamoid (0.63 MPa). The medial phalanx region of the right joint was the most permeable (4.56 x 10(-15) meter4/Newton-second), whereas the medial sesamoid articulation of the metatarsal head of the left joint was the least permeable (1.26 x 10(-15) meter4/Newton-second). Material properties and thickness are indicative of the tissue's functional environment. The lack of mismatches in cartilage biomechanical properties of the articulating surfaces found in this study may be supportive of clinical observations that early degenerative changes, in the absence of traumatic events, do not occur at the selected test sites in the human first metatarsophalangeal joint.     

An analysis of hip joint loading during walking, running, and skiing

PURPOSE: It was the purpose of this study to investigate loading of the hip joint during various skiing activities and to compare the results with walking and running. The results are relevant to determine which skiing activities can be recommended for patients after total hip replacement. METHODS: Nine male subjects were instrumented with a 12-channel accelerometer system mounted on the upper body. Data were collected during walking, running, and six skiing activities and used as input for an inverse dynamic analysis that resulted in the time histories of the intersegmental force and moment at the supporting hip joint. Joint contact force was computed using a simple muscle model. Peak values were determined, averaged over all loading cycles, and compared between activities. RESULTS: Intersegmental force, indicating the influence of upper body weight and accelerations, was highest during running. Intersegmental moments were highest during the alpine skiing activities and indicated large extensor muscle forces at the hip joint. The peak joint contact force during walking at 1.5 m x s(-1) was 2.5+/-0.3 times body weight (BW). Running at 3.5 m x s(-1) produced a joint contact force of 5.2+/-0.4 BW during the push-off phase. Joint contact forces during four different alpine skiing conditions ranged from 4.1+/-0.6 BW (long turns, flat slope) to 7.8+/-1.5 BW (short turns, steep slope). Cross-country skiing had lower hip joint loading than running but higher than walking: 4.0+/-1.1 BW for classical technique and 4.6+/-0.6 BW for skating technique. CONCLUSIONS: Assuming that walking is a "safe" activity for a hip prosthetic patient, controlled alpine skiing and cross-country skiing appear relatively safe with respect to the magnitude of loading. However, the skiing activities showed considerably higher mediolateral and anterior-posterior forces than walking. Mechanical testing of prosthetic devices with loading conditions specific to these activities is needed to assess the effect of these force components on hip prostheses and to allow interpretation with respect to potential effects of skiing for a hip prosthetic patient.     

Three-dimensional thickness and volume measurements of the knee joint cartilage by MR tomography: reproducibility in volunteers]

A rapidly expanding number of genetic mechanisms contributing to disease can be accessed via molecular analysis. In order to take full advantage of this potential for genetic diagnostics, and to monitor treatment by gene therapy and other emerging methods, a new generation of diagnostic techniques will be required. Of central importance in future analyses is the possibility to perform very large numbers of simultaneous genetic analyses in analytical devices of small linear dimensions. We have developed a new molecular probe design that is amenable to highly multiplex, specific analyses of total genomic DNA or of RNA molecules expressed in tissue samples. Here, a brief history of gene analytical procedures is presented, followed by a discussion of the properties, means of synthesis and applications of this new class of gene analytic reagents, padlock probes.     

Mechanobiological adaptation of subchondral bone as a function of joint incongruity and loading

Computed tomography (CT) has been employed to determine non-invasively the distribution of subchondral bone density in joints and to evaluate their dominant loading pattern. The objective of this study was to investigate the relationship between subchondral bone adaptation, joint incongruity and loading, in order to determine to what extent the loading conditions and/or geometric configuration can be inferred from the distribution of subchondral density. Finite element models of joints with various degrees of incongruity were designed and a current remodeling theory implemented using the node-based approach. Appropriate combinations of joint incongruity and loading yielded subchondral bone density patterns consistent with experimental findings, specifically a bicentric distribution in the humero-ulnar joint and a monocentric distribution in the humero-radial joint. However, other combinations of incongruity and loading produced similar subchondral density patterns. Both the geometric joint configuration and the loading conditions influence the distribution of subchondral density in such a way that one of these factors must be known a priori to estimate the other. Since subchondral density can be assessed by CT and joint geometry by magnetic resonance imaging, the dominant loading pattern of joints may be potentially derived in the living using these non-invasive imaging methods.     

Measurement of localized cartilage volume and thickness of human knee joints by computer analysis of three-dimensional magnetic resonance images

RATIONALE AND OBJECTIVES: This work demonstrates a new method for computerized measurement of the dimensions (thickness and volume) of articular cartilage for any specified region of the human knee joint. Three-dimensional magnetic resonance (MR) images optimized for cartilage contrast have been analyzed using computerized edge-detection techniques, and the reproducibility of articular cartilage thickness and volume measurements is assessed. METHODS: A fat-suppressed, three-dimensional SPoiled GRass MR sequence (45/7.5/30 degrees) with total scan time of approximately 12 minutes was used to acquire volume images of human knee joints at spatial resolution of 0.6 x 1.2 x 1.2 mm. Measurements were made using six repeated scans for three healthy volunteers over a period of 2 months. The subsequent semi-automated image processing to establish total cartilage volume and cartilage thickness maps for the femur required approximately 60 minutes of operator time. RESULTS: The mean coefficient of variation for total cartilage volume for the six repeated scans for the three volunteers was 3.8%, and the average coefficient of variation for the user-selected cartilage plugs was 2.0%. The cartilage thickness maps from the repeated scans of the same knee were similar. CONCLUSIONS: Standard resolution MR images with fat-suppressed contrast lead to an objective and reproducible measurement of spatial dimensions of articular cartilage when analyzed semi-automatically using computerized edge-detection methods.     

Stress analysis of the human temporomandibular joint

OBJECTIVE: To examine how dietary intake varies with age in a nation-wide sample of adult Norwegian women, and to evaluate the impact of lifestyle and socio-economic status on important dietary aspects. DESIGN: Cross-section study. SETTING AND SUBJECTS: A food frequency questionnaire was mailed to a random, nation-wide sample of 20 000 women aged 45-69y, and 9885 questionnaires were accepted for nutritional analyses. RESULTS: Dietary habits differed moderately with age. The oldest women reported a higher consumption of potatoes and fish, whereas the youngest reported more coffee, meat, and alcohol. The reported intake of fruit, vegetables, and potatoes was lower than recommended in all age groups. Older women had a slightly better distribution of energy yielding nutrients than younger women, although the median percentage of energy from fat was too high in all age groups. The median dietary fibre density of the diet was close to the recommended level in all age groups, yet lowest among the youngest women. Practising a healthy lifestyle and having a higher socio-economic status were associated with reporting a healthier diet. However, adjusting for lifestyle and socio-economic factors did not substantially alter the associations between diet and age. CONCLUSIONS: Older women tend to have a healthier diet than younger women. The relationship does not seem to be strongly confounded by lifestyle and socio-economic status, although these factors are also related to dietary habits.     

Human joint performance and the roughness of articular cartilage

The Doppler technique has been used to evaluate venous reflux in the spermatic cord. Valsalva-induced reflux occurred on the left side in 83% and on the right side in 59% of 118 patients without clinical varicoceles and there was no difference in incidence between fertile and infertile men. The significance of Valsalva-induced reflux should be questioned. Greater importance should be attributed to the spontaneous venous reflux that occurred during quiet respiration in the majority of patients with varicoceles. Seven velocity waveform patterns are described and these are thought to represent increasing degrees of internal spermatic vein reflux and provide a basis on which it is possible to grade varicoceles. The Doppler grades correlated with the size of the varicocele, and with the internal spermatic vein diameter and testosterone concentrations.     

Contact areas in the thumb carpometacarpal joint

The thumb carpometacarpal joint is a common site of osteoarthritis. It has been hypothesized that peaks of localized stress on the dorsoradial or volar-ulnar regions, or both, of the articular surfaces of the trapezium and metacarpal lead to erosion of cartilage and may be responsible for the progression of the disease. The objective of this study was to determine the contact areas in this joint under the functional position of lateral (key) pinch and in the extremes of range of motion of the joint. These contact areas were assessed relative to the observed sites of cartilage thinning. Eight hands from cadavers of women and five from cadavers of men were tested in vitro with the thumb under a 25 N load in the lateral pinch position, and under small muscle loads (0-5 N) with the thumb in flexion, extension, abduction, adduction, and neutral positions. Contact areas of articular surfaces of the thumb carpometacarpal joint were determined for these positions using a stereophotogrammetric technique. The lateral pinch position produced contact areas predominantly on the central, volar, and volar-ulnar regions of the trapezium and the metacarpal. In three specimens, contact areas were distinctly separated between the dorsoradial and volar-ulnar regions, and in one specimen, from a man, contact occurred exclusively on the dorsoradial region of the trapezium. Using stereophotogrammetry, maps of cartilage thickness also were determined for a subset of nine specimens. The volar-ulnar, ulnar, and dorsoradial regions of the trapezium were the most common sites of thin cartilage, and these may be sites of cartilage wear.(ABSTRACT TRUNCATED AT 250 WORDS)     

Quantitative measurement of joint space narrowing progression in hip osteoarthritis: a longitudinal retrospective study of patients treated by total hip arthroplasty

OBJECTIVES: To evaluate the rate of progression of radiological joint space narrowing (JSN) in patients operated on for hip osteoarthritis (OA) and to determine its predictive factors. METHODS: Study design: retrospective longitudinal trial of 61 patients who underwent total hip arthroplasty (THA) for hip OA (69 operated hips). Mean follow-up 81.2 +/- 9.9 months. Collected data: (1) standing frontal radiographs of the pelvis from diagnosis to surgery (246 films) for morphological evaluation and quantitative measurement of joint space width (JSW) (computerized reading of digitized X-rays); (2) demographic data (sex, age, body mass index, smoking status, professional and sporting activities, family history of OA); (3) clinical data (age at onset-diagnosis and THA, drug consumption, time from diagnosis to permanent disability, OA at other joints, previous THA of the contralateral hip). Statistics: multivariate analysis. RESULTS: The yearly mean narrowing (YMN) of MeanJSW was 0.43 +/- 0.43 mm/yr (median 0.29, range 0.03-2.55). YMN correlated inversely with joint space width at operation and follow-up duration, and was increased in atrophic OA (r = 0.71). The time between diagnosis and THA correlated with JSW at diagnosis, and was inversely correlated with age at onset and YMN. It was longer in patients with hypertrophic OA (r = 0.69). CONCLUSION: Rapid progression of JSN, older age and absence of osteophytes appear to be the main factors leading to THA.     

Morphomechanics of the humero-ulnar joint: I. Joint space width and contact areas as a function of load and flexion angle

BACKGROUND: Previous studies have shown that the trochlear notch is deeper than necessary for an exact fit with the humerus. However, humero-ulnar joint space width and contact areas have so far not been quantified for variations in the load and angle of flexion. METHODS: Six fresh cadaveric specimens were investigated at 30 degrees, 60 degrees, 90 degrees, and 120 degrees of flexion and at loads of 25 and 500 N, simulating resisted elbow extension. The joint space width and contact were determined, using polyether casting material. RESULTS: At 25 N all joints made contact in the ventral and dorsal aspects of the articular surfaces, whereas in the depth of the trochlear notch the joint space was on average between 0.3 and 2.8 mm wide, with some variation between individuals. At 500 N the joint space width was considerably reduced and the contract areas expanded towards the depth of the notch. The size of the dorsal contact areas was significantly smaller at 30 degrees and that of the ventral ones at 120 degrees, their ventro-dorsal ratio decreasing considerably from 30 degrees to 120 degrees (p < 0.01). CONCLUSION: These results indicate that the size of the contact areas depends to a slight extent on the joint position, but that at all loads and flexion angles a bicentric contact and an important central joint space width emerge because of the concave incongruity of the joint. These data may be used for numerical calculations, analysing the effects of incongruity on the joint stress and on the functional adaptation of the subarticular tissues.     

Aptitude for trance, task generalizability, and incongruity response in hypnosis.

Current theorizing about the process of "tolerance of logical incongruity" in hypnosis suggests that (a) aptitude for trance will be postively related to its occurrence, and (b) paradoxical behavior will manifest itself relatively consistently across different kinds of tasks presumed to measure the process. In a test of these predictions, 6 independent sets of 12 college students preselected for susceptibility to hypnosis (Harvard Group Scale of Hypnotic Susceptibility, Form A), were allocated to a 3 by 2 (Aptitude for Hypnosis by Instruction) factorial design. High-, medium-, and low-aptitude Ss were given either standard hypnotic or motivated waking imagination instructions, Ss being tested on 5 neutral (no incongruity) and 7 experimental items measuring incongruity. Results show that aptitude for trance determined incongruity response among both waking and hypnotic Ss, but that tolerance of incongruity could not reasonably be represented on currently accepted tests as a cognitive trait that exerts stable, enduring effects. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vacuum phenomenon in the hip joint: diagnostic value

Vacuum phenomenon is well known in degenerative spinal disease in the elderly, but is seldom seen in other joints, especially in children. The phenomenon does not represent a pathological finding, and can be used for imaging of the articular facets, mainly in the hip and knee joints. We report a patient with this phenomenon in the hip joint.     

The effect of triple pelvic osteotomy on the articular contact area of the hip joint in dysplastic dogs: an in vitro experimental study

This study compares the frequency of signs and symptoms from the cervical spine in 24 patients diagnosed with Meniere's disease and 24 control subjects from a population sample. From a previous controlled comparative study concerning signs and symptoms of craniomandibular disorders, 24 patients diagnosed with Meniere's disease (10 males and 14 females) and their 24 matched control subjects participated in this investigation on the state of the cervical spine. Symptoms of cervical spine disorders, such as head and neck/shoulder pain, were all significantly more frequent in the patient group than in the control group. Most of the patients (75%) reported a strong association between head neck movements in the atlanto-occipital and atlanto-axial joints and triggered attacks of vertigo. Also, 29% of the patients could influence their tinnitus by mandibular movements. Signs of cervical spine disorders, such as limitations in side-bending and rotation movements, were significantly more frequent in the patient group than in the control group. Tenderness to palpation of the transverse processes of the atlas and the axis, the upper and middle trapezius, and the levator scapulae muscle were also significantly more frequent in the patient group. The study shows a much higher prevalence of signs and symptoms of cervical spine disorders in patients diagnosed with Meniere's disease compared with control subjects from the general population.     

Distribution of contact force during impact to the hip

The aim of the present study was to investigate the effects of almokalant on sustained reentrant supraventricular tachycardias. Reentrant tachycardias were induced, using transesophageal atrial stimulation, in 82 patients with atrioventricular reentrant tachycardia (n = 54) or AV nodal reentrant tachycardia (n = 28). After a baseline procedure during which the tachycardia was induced and overdrive terminated, the tachycardia was reinduced and studied during 12 minutes of infusion of either placebo or almokalant, aiming at plasma concentrations of 20, 50, 100, and 150 nmol/l. Each patient was studied at two dose levels during the same procedure. There was an increase in the RR interval during tachycardia of 6% at 100 nmol/l (p = 0.001 vs. baseline tachycardia). The QT interval during tachycardia increased by 5% (p = 0.001) at 50 nmol/l and by 10% (p = 0.001) at 100 nmol/l. Bundle branch block during tachycardia developed in 13% during almokalant infusion, aiming at 20 nmol/l, in 25% at 50 nmol/l, in 50% at 100 nmol/l, and in 33% at 150 nmol/l. Rapid baseline tachycardia, increasing almokalant dose, and an increasing number of induced tachycardias correlated with the appearance of bundle branch block. In six patients with AV nodal reentrant tachycardia, 2:1 AV block occurred, in all cases preceded by bundle branch block. The QT prolongation during sustained tachycardia was larger in patients who were noninducible at the same plasma concentration level than in the inducible patients. Almokalant caused bundle branch block and 2:1 AV block during sustained supraventricular tachycardia. These findings emphasize the importance of studying drug effects at rates in the range of clinical tachycardias that expose the conduction system to the limits of its refractoriness.     

Expression of anchorin CII (cartilage annexin V) in human young, normal adult, and osteoarthritic cartilage

In its tissue-specific function as a collagen receptor of chondrocytes, cartilage annexin V (anchorin CII) occupies a key position in the organization of the cell-extracellular matrix (ECM) junction for the tissue. The general role of annexin V (Anx V) in other tissues suggests involvement in cellular secretory processes and in regulation of apoptosis. Immunohistochemical analysis of Anx V in growth plate cartilage, confirmed by in situ hybridization, suggests that Anx V is prominently expressed and forms a major constituent of growth plate chondrocytes. Anx V epitopes are also located in the pericellular matrix of hypertrophic cartilage. In adult articular cartilage the expression is downregulated, with the highest levels of immunostaining found in the upper third of the articular cartilage layers and almost no antigen found in the deep layers. Osteoarthritic (OA) cartilage is characterized by a significant upregulation of message and protein throughout the entire depth of the tissue, an accumulation of cytoplasmic annexin V epitopes, and a release of epitopes into the pericellular and interterritorial matrix, in part co-localized with granular structures. Therefore, Anx V expression and tissue distribution may serve as a histological marker for metabolic alterations and for changes in the cellular phenotype associated with OA.