von Eisenhart R, Adam C, Steinlechner M, Müller-Gerbl M, Eckstein F
Musculoskeletal Research Group, Anatomische Anstalt, Ludwig-Maximilians-Universität, München, Germany.
J Orthop Res. 1999 Jul;17(4):532-9. doi: 10.1002/jor.1100170411.
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 eight 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 magnitudes 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 load-sharing 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.
本研究的目的是提供同一组标本在模拟步行周期中髋关节不匹配和压力以及关节软骨厚度的定量数据。我们采用铸造技术对八个成人髋关节标本（年龄：18 - 75岁）进行研究，确定了步态周期四个阶段在最小负荷下实现接触所需的关节间隙宽度（不匹配度）。基于髋关节力的体内测量结果，使用压敏膜测定生理负荷下的压力分布。采用A模式超声评估软骨厚度。在最小负荷下，髋臼顶关节间隙的平均最大宽度在1.1至1.5毫米之间，在整个步态周期中接触区域位于腹侧上方和背侧下方。在生理负荷下，间隙宽度减小，在站立中期和足跟离地时接触区域覆盖整个关节表面，但在足跟触地或足尖离地时则不然。在所有阶段压力分布均不均匀，站立中期的平均最大压力为7.7±1.95兆帕。关节表面各处的软骨厚度差异很大；在腹侧上方发现最大值超过3毫米。这些数据可用于生成和验证计算机模型，以确定关节软骨间质液与固体蛋白聚糖 - 胶原基质之间的负荷分担情况，后者与机械诱导的软骨退变的起始有关。
