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.