Abstract
Purpose
Mineralization distribution of the subchondral bone plate can be used as a marker for long-term stress distribution in diarthrodial joints. Severe injuries or pathological changes of the glenohumeral joint often end in osteoarthritis, where shoulder arthroplasty has become the treatment of choice. The computed tomography osteoabsorptiometry (CT-OAM) is a non-invasive method to determine the distribution of the mineralization of the subchondral bone plate in vivo, which is an important factor concerning the implantation of orthopedic endoprostheses. The aim of this study was to investigate the mineralization of both joint partners of the glenohumeral joint and to compare them with each other.
Methods
The distribution of the mineralization of the subchondral bone plate of 57 shoulder specimens was determined by means of CT-OAM. To evaluate a correlation between age and localization of subchondral mineralization maxima, the Chi-square test correlation test was applied.
Results
Forty-nine glenoid cavities (86 %) showed a bicentric mineralization distribution pattern with anterior and posterior maxima, only 8 glenoid cavities (14 %) revealed a monocentric mineralization pattern with anterior maxima. Forty-five humeral heads (79 %) showed a bicentric distribution pattern with anterior and posterior maxima, 12 humeral heads (21 %) could be classified as monocentric with a centro-posterior pronounced maximum.
Conclusions
We could demonstrate that stress distribution in both joint partners of the glenohumeral joint is inhomogeneous and characteristically bicentric due to the physiological incongruity. Monocentric mineralization patterns can result as a cause of age-related loss of incongruity.
Similar content being viewed by others
References
Aitken GK, Bourne RB, Finlay JB, Rorabeck CH, Andreae PR (1985) Indentation stiffness of the cancellous bone in the distal human tibia. Clin Orthop Relat Res 201:264–270
Bullough PG (1981) The geometry of diarthrodial joints, its physiologic maintenance, and the possible significance of age-related changes in geometry-to-load distribution and the development of osteoarthritis. Clin Orthop Relat Res 156:61–66. doi:10.1097/00003086-198105000-00008
Carter DR, Fyhrie DP, Whalen RT (1987) Trabecular bone density and loading history: regulation of connective tissue biology by mechanical energy. J Biomech 20(8):785–794
Chapman JR, Harrington RM, Lee KM, Anderson PA, Tencer AF, Kowalski D (1996) Factors affecting the pullout strength of cancellous bone screws. J Biomech Eng 118(3):391–398
Collins D, Tencer A, Sidles J, Matsen F 3rd (1992) Edge displacement and deformation of glenoid components in response to eccentric loading. The effect of preparation of the glenoid bone. J Bone Joint Surg Am 74(4):501–507
Frost HM (1990) Skeletal structural adaptations to mechanical usage (SATMU): 2. Redefining Wolff’s law: the remodeling problem. Anat Rec 226(4):414–422. doi:10.1002/ar.1092260403
Gordon KD, Duck TR, King GJ, Johnson JA (2003) Mechanical properties of subchondral cancellous bone of the radial head. J Orthop Trauma 17(4):285–289
Hofmann AA, Hammon DJ, Daniels AU (1991) Compressive strength mapping of femoral head trabecular bone. J Rehabil Res Dev 28(2):25–32
Imhof H, Sulzbacher I, Grampp S, Czerny C, Youssefzadeh S, Kainberger F (2000) Subchondral bone and cartilage disease: a rediscovered functional unit. Invest Radiol 35(10):581–588
Kraljevic M, Zumstein V, Wirz D, Hugli R, Muller-Gerbl M (2011) Mineralisation and mechanical strength of the glenoid cavity subchondral bone plate. Int Orthop. doi:10.1007/s00264-011-1308-5
Lane LB, Villacin A, Bullough PG (1977) The vascularity and remodelling of subchondral bone and calcified cartilage in adult human femoral and humeral heads. An age- and stress-related phenomenon. J Bone Joint Surg Br 59(3):272–278
Matsen FA, Lippitt SB, Sidles JA, Harryman DT (1994) Practical evaluation and management of the shoulder. WB Saunders, Philadelphia
Muhlhofer H, Ercan Y, Drews S, Matsuura M, Meissner J, Linsenmaier U, Putz R, Muller-Gerbl M (2009) Mineralisation and mechanical strength of the subchondral bone plate of the inferior tibial facies. Surg Radiol Anat 31(4):237–243. doi:10.1007/s00276-008-0430-6
Muller-Gerbl M (1998) The subchondral bone plate. Adv Anat Embryol Cell Biol 141(III-XI):1–134
Muller-Gerbl M, Putz R, Hodapp N, Schulte E, Wimmer B (1989) Computed tomography-osteoabsorptiometry for assessing the density distribution of subchondral bone as a measure of long-term mechanical adaptation in individual joints. Skeletal Radiol 18(7):507–512
Muller-Gerbl M, Putz R, Hodapp N, Schulte E, Wimmer B (1990) Demonstration of subchondral density pattern using CT-osteoabsorptiometry (CT-OAM) for the assessment of individual joint stress in live patients. Z Orthop Ihre Grenzgeb 128(2):128–133. doi:10.1055/s-2008-1039487
Muller-Gerbl M, Putz R, Kenn R (1992) Demonstration of subchondral bone density patterns by three-dimensional CT osteoabsorptiometry as a noninvasive method for in vivo assessment of individual long-term stresses in joints. J Bone Miner Res 7(Suppl 2):S411–S418. doi:10.1002/jbmr.5650071409
Muller-Gerbl M, Putz R, Kenn R (1993) Distribution pattern of subchondral mineralization in the glenoid cavity in normal subjects, athletes and patients. Z Orthop Ihre Grenzgeb 131(1):10–13. doi:10.1055/s-2008-1039896
Muller-Gerbl M, Weisser S, Linsenmeier U (2008) The distribution of mineral density in the cervical vertebral endplates. Eur Spine J 17(3):432–438. doi:10.1007/s00586-008-0601-5
Oberlander W (1973) The stress of the human hip joint. V. The distribution of bone density in the human acetabulum (author’s transl). Z Anat Entwicklungsgesch 140(3):367–384. doi:10.1007/BF00525062
Pauwels F (1965) Eine Theorie über den Einfluss mechanischer Reize auf dei Differenzierung der Stützgewebe. Z Anat Entwicklungsgesch 121:478–515
Schulz CU, Pfahler M, Anetzberger HM, Becker CR, Muller-Gerbl M, Refior HJ (2002) The mineralization patterns at the subchondral bone plate of the glenoid cavity in healthy shoulders. J Shoulder Elbow Surg 11(2):174–181. doi:10.1067/mse.2002.121635
Skirving AP (1999) Total shoulder arthroplasty—current problems and possible solutions. J Orthop Sci 4(1):42–53. doi:10.1007/s007760050073
Soslowsky LJ, Flatow EL, Bigliani LU, Mow VC (1992) Articular geometry of the glenohumeral joint. Clin Orthop Relat Res 285:181–190
Tillmann B (1971) The stress of the human elbow joint. I. Functional morphology of the articular surfaces. Z Anat Entwicklungsgesch 134(3):328–342. doi:10.1007/BF00519919
Torchia ME, Cofield RH, Settergren CR (1997) Total shoulder arthroplasty with the Neer prosthesis: long-term results. J Should Elb Surg 6(6):495–505. doi:10.1016/S1058-2746(97)90081-1
von Eisenhart-Rothe R, Muller-Gerbl M, Wiedemann E, Englmeier KH, Graichen H (2008) Functional malcentering of the humeral head and asymmetric long-term stress on the glenoid: potential reasons for glenoid loosening in total shoulder arthroplasty. J Should Elb Surg 17(5):695–702. doi:10.1016/j.jse.2008.02.008
Walch G, Badet R, Boulahia A, Khoury A (1999) Morphologic study of the glenoid in primary glenohumeral osteoarthritis. J Arthroplast 14(6):756–760. doi:10.1016/S0883-5403(99)90232-2
Wolff J (1892) Das Gesetz der Transformation der Knochen. August Hirschwald Verlag, Berlin
Zumstein V, Kraljevic M, Huegli R, Muller-Gerbl M (2011) Mineralisation patterns in the subchondral bone plate of the humeral head. Surg Radiol Anat. doi:10.1007/s00276-011-0819-5
Zumstein V, Kraljevic M, Wirz D, Hugli R, Muller-Gerbl M (2012) Correlation between mineralization and mechanical strength of the subchondral bone plate of the humeral head. J Should Elb Surg 21(7):887–893. doi:10.1016/j.jse.2011.05.018
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical standards
All experiments comply with the current laws of Switzerland.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kraljević, M., Zumstein, V., Hügli, R. et al. A comparison of subchondral bone mineralization between the glenoid cavity and the humeral head on 57 cadaverous shoulder joints. Surg Radiol Anat 35, 295–300 (2013). https://doi.org/10.1007/s00276-012-1034-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-012-1034-8