Subchondral bone density in the human elbow assessed by computed tomography osteoabsorptiometry: a reflection of the loading history of the joint surfaces.

The functional adaptation of bone tissue to the mechanical stresses acting on it has been convincingly established. This association should apply as well to the subchondral bone, reflecting the long-term distribution of stress over the joint surfaces. Thirty-six specimens of the human elbow joint were investigated by computed tomography osteoabsorptiometry in order to assess the distribution of the subchondral mineralization. The distal surfaces usually were more highly mineralized than the proximal components of the joint, whereas the humeroulnar and the humeroradial parts exhibited a similar degree of mineralization. The fovea of the radial head always showed a central density maximum, and the trochlear notch usually presented a bicentric distribution pattern, with maxima beneath the ventral and dorsal regions of the articular surface. The different patterns of subchondral mineralization were shown to reflect the loading history of the overlying articular surfaces, which is determined mainly by geometrical factors. The flatter socket of the humeroradial joint leads to central load transmission, but the deeper socket of the humeroulnar joint will, by contrast, give rise to bicentric stress distribution.