Morphometric study of the fetal development of the human hip joint: significance for congenital hip disease.

Hip joints (280) from 140 human fetuses, obtained from abortions and deaths in the perinatal period, were studied. The fetuses ranged from 8.7 to 40 cm in crown-rump length and are believed to be between 12 and 42 weeks in age. The joints were dissected, morphology inspected, and measurements taken of the depth and diameter of the acetabulum, the diameter of the femoral head, length and width of the ligament of the head, the neck-shaft, and torsion angles of the proximal femur. Regression models were fitted to determine which would best predict the growth pattern. Multivariate analysis of variance showed no significant differences between males and females or between the right and left sides. Acetabular depth was shown to be the slowest-growing hip variable, increasing less than fourfold in the period studied. Acetabular indices less than 50 percent indicate a shallow socket at term. Femoral head and acetabular diameter demonstrated a strong relationship (r = 0.860) and in many joints the femoral head diameter exceeded that of the acetabulum. Considerable variability was demonstrated in both femoral angles. The femoral angles showed only low correlation with the other hip variables. These observations indicate that soft tissue structures about the joint must play an important role in neonatal joint stability. The explanation of greater female and left side involvement in congenital hip disease must lie in factors other than growth changes of hip dimensions. Neither angle appears to be a useful indicator of normal joint development.     

Dysplasia of the hip; a factor in the development of static osteoarthropathy

Dysplasia of the hip is associated with a shallow acetabulum. It may be present and unrecognized until middle age when arthritic changes develop as a result of repeated microtraumata. By that time the process is irreversible. It can be recognized in infancy by roentgenographic study of the hips, and corrective measures can be taken to develop a normal hip and so prevent the crippling arthritis of later life. Although it is not certain that dysplasia develops in every person having a shallow acetabulum, this structural abnormality is known to be a strongly predisposing factor and therefore should be corrected.     

DYSPLASIA OF THE HIP: A FACTOR IN THE DEVELOPMENT OF STATIC OSTEOARTHROPATHY

Dysplasia of the hip is associated with a shallow acetabulum. It may be present and unrecognized until middle age when arthritic changes develop as a result of repeated microtraumata. By that time the process is irreversible.It can be recognized in infancy by roentgenographic study of the hips, and corrective measures can be taken to develop a normal hip and so prevent the crippling arthritis of later life. Although it is not certain that dysplasia develops in every person having a shallow acetabulum, this structural abnormality is known to be a strongly predisposing factor and therefore should be corrected.     

Histological study of the fetal development of the human acetabulum and labrum: significance in congenital hip disease.

Seventy-four acetabula from a total of 140 normal human fetuses, obtained from abortions and deaths in the prenatal period, were used. The fetuses ranged from 9.1 to 40 cm in crown-rump length and are believed to be between 12 weeks and term. Acetabula were decalcified embedded in paraffin or celloidin, sectioned, and stained using conventional histologic techniques. Sections from the superior one-quarter of the acetabulum were examined for the initial appearance and later spread of osseous tissue. Throughout the fetal period bone was present only in the floor of the acetabulum and did not extend into the socket walls. Ossification was detected initially more posteriorly in the socket floor, and at all ages, ossification was more prominent on the ischial side of the socket. Despite the lack of osseous tissue a well-formed hyaline cartilage socket was present. The fetal labrum was composed of fibrous tissue with the density of fibers increasing with age. Typical-appearing chondrocytes were detected at only the inner articular margin of the labrum. Contributing from one-fifth to one-half of the socket depth, the labrum may play a greater role in containing the femoral head at birth than it does in the mature joint. In seven acetabula, from joints that were neither subluxated nor dislocated, an area of areolar tissue with capillaries was detected at the hyaline cartilage-labrum junction. Such defects may weaken the labrum and contribute to neonatal hip instability.     

"In vivo" determination of hip joint separation and the forces generated due to impact loading conditions

Numerous supporting structures assist in the retention of the femoral head within the acetabulum of the normal hip joint including the capsule, labrum, and ligament of the femoral head (LHF). During total hip arthroplasty (THA), the LHF is often disrupted or degenerative and is surgically removed. In addition, a portion of the remaining supporting structures is transected or resected to facilitate surgical exposure. The present study analyzes the effects of LHF absence and surgical dissection in THA patients. Twenty subjects (5 normal hip joints, 10 nonconstrained THA, and 5 constrained THA) were evaluated using fluoroscopy while performing active hip abduction. All THA subjects were considered clinically successful. Fluoroscopic videos of the normal hips were analyzed using digitization, while those with THA were assessed using a computerized interactive model-fitting technique. The distance between the femoral head and acetabulum was measured to determine if femoral head separation occurred. Error analysis revealed measurements to be accurate within 0.75mm. No separation was observed in normal hips or those subjects implanted with constrained THA, while all 10 (100%) with unconstrained THA demonstrated femoral head separation, averaging 3.3mm (range 1.9-5.2mm). This study has shown that separation of the prosthetic femoral head from the acetabular component can occur. The normal hip joint has surrounding capsuloligamentous structures and a ligament attaching the femoral head to the acetabulum. We hypothesize that these soft tissue supports create a passive, resistant force at the hip, preventing femoral head separation. The absence of these supporting structures after THA may allow increased hip joint forces, which may play a role in premature polyethylene wear or prosthetic loosening.     

The transmission of load through the human hip joint

This paper describes the results of loading experiments carried out on human hip joints. The unloaded surfaces of the femoral head and the acetabulum are slightly incongruous. The location and magnitude of the contact areas between the surfaces therefore depend on the magnitude and direction of the applied load. The contact areas were determined experimentally for a variety of loads typical of normal walking. Two distinct contact areas were found on the anterior and posterior aspects of the acetabulum at light loads, gradually merging with increasing load until, at a certain transition load, the dome of the acetabulum comes into contact and contact is then complete. The value of the transition load depends on the rate of loading, due to creep of the cartilage, and was found to vary from 50 per cent of body weight in young specimens to 25 per cent of body weight for elderly specimens for rates of loading typical of normal walking. Thus, the dome of the acetabulum is out of contact for a substantial portion of the swing phase of normal walking.

The analysis of a much simplified model of the hip joint is presented. The dependence of contact area on load is demonstrated, but also a method of determining the transition load for complete contact from the load/deflection relation for the hip is suggested. The values of the transition load quoted above were obtained by this method. The analysis further indicates that the distribution of pressure between the articular surfaces depends critically on the distribution of cartilage thickness throughout the joint. It is suggested that the distribution of cartilage thickness is such as to lead to a state of uniform pressure at the upper end of the physiological load range. Some experimental evidence is presented in support of this suggestion.

It is concluded that the function of joint incongruity is to allow the articular surfaces to come out of contact at light loads so that the cartilage may be exposed to synovial fluid for the purposes of nutrition and lubrication. At large loads, the distribution of cartilage thickness ensures that a state of hydrostatic pressure is achieved in order that cartilage, with a large fluid content, may transmit large pressures without flow and consequent loss of its integrity.     

Shape of the pelvis and posture of the hindlimbs inPlateosaurus

The pelvis ofPlateosaurus is examined from a biomechanical point of view. The shape of the acetabulum in particular is analysed in order to determine the range of possible directions of the forces exchanged between femur and pelvis. These forces must have been more or less confined to a sagittal plane. From a quasi-static analysis under consideration of the major hip muscles ofPlateosaurus, a nearly but not fully extended posture of the hindlimbs can be deduced. The hip joints ofPlateosaurus and probably of some other dinosaurs with a narrow biacetabular width were balanced rather by adducting than by abducting muscles.     

Regional load bearing of the canine acetabulum

OBJECTIVE: To determine the load bearing areas of the canine acetabulum. MATERIALS AND METHODS: A kinematic study of four healthy dogs was used to determine the orientation of the femur to the pelvis at mid-stance. Femora and pelves from 10 canine cadavers were loaded with the physiological canine hip reaction force and angle being replicated. Impression material placed within the acetabulum was extruded from areas of load bearing. Digital images before and after loading were used to assess if six different regions of the acetabulum were fully, partially or non-load bearing. RESULTS: All areas of the acetabulum were partially or fully load bearing. The cranial and caudal thirds of the acetabulum were 7.9 and 13.1 times more likely to be fully load bearing than the central third, respectively. There was a significant difference in load bearing between the axial, middle and abaxial thirds of the acetabulum in all tests, with the middle and abaxial thirds 72.4 and 351 times more likely to be fully load bearing than the axial third, respectively. CONCLUSION: The cranial and caudal thirds and the middle and abaxial thirds of the canine acetabulum are fully load bearing. CLINICAL RELEVANCE: The caudal third of the canine acetabulum is loaded and therefore recommendations that fractures in this area be managed conservatively need to be reconsidered.     

Finite element analysis of a hemi-pelvis: the effect of inclusion of cartilage layer on acetabular stresses and strain

An appropriate method of application of the hip-joint force and stress analysis of the pelvic bone, in particular the acetabulum, is necessary to investigate the changes in load transfer due to implantation and to calculate the reference stimulus for bone remodelling simulations. The purpose of the study is to develop a realistic 3D finite element (FE) model of the hemi-pelvis and to assess stress and strain distribution during a gait cycle. The FE modelling approach of the pelvic bone was based on CT scan data and image segmentation of cortical and cancellous bone boundaries. Application of hip-joint force through an anatomical femoral head having a cartilage layer was found to be more appropriate than a perfectly spherical head, thereby leading to more accurate stress–strain distribution in the acetabulum. Within the acetabulum, equivalent strains varied between 0.1% and 0.7% strain in the cancellous bone. High compressive (15–30 MPa) and low tensile (0–5 MPa) stresses were generated within the acetabulum. The hip-joint force is predominantly transferred from the acetabulum through the lateral cortex to the sacroiliac joint and the pubic symphysis. The study is useful to understand the load transfer within the acetabulum and for further investigations on acetabular prosthesis.     

Two cases of joint disease in post-medieval church cemetery of St. Ilija

Evidence of disease was analyzed from the skeletal remains of 11 individuals dating to the post-Medieval period from church cemetery of St. Ilija in Serbia. Two individuals showed pathological condition affecting joints. It was supposed that first individual had been suffering from Legg-Calvé-Perthes disease. It seems that this condition remained untreated, with extensive bone remodeling, and that the deformity of femoral head and acetabulum caused secondary degenerative joint disease at a relatively early age of this individual. Second case was related to the bony akylosis of the hand finger, probably caused by Dupuytren's disease. In addition, we discussed development of differential diagnosis in both pathological conditions.     

太行山猕猴髋臼性别二态性研究

本文使用几何形态测量法探讨42例成年太行山猕猴Macaca mulatta tcheliensis髋臼的性别二态性。结果显示,太行山猕猴雌雄个体的髋臼形态具有明显的性别二态性,利用髋臼可以正确判别92.3%的雌性和87.5%的雄性个体。髋臼的形态差异主要分布于月状面的后上部,即与髋臼切迹相对的月状面区域的宽度表现为雄性大于雌性,另外雄性髋臼大小的波动范围也比雌性更广。造成髋臼性别二态性的生物学原因可能与其功能有关,髋臼作为髋关节的组成部分,起着支撑身体和协同运动的功能,能够优化关节接触面的压力分布。推测雄性髋臼受到的体质量压力更大可能是雄性进化出比雌性更宽大的月状面的主要原因。     

Characterization of a nicotinamide nucleotide transhydrogenase gene from the green alga Acetabularia acetabulum and comparison of its structure with those of the corresponding genes in mouse and Caenorhabditis elegans

Proton-pumping nicotinamide nucleotide transhydrogenase (Nnt) is a membrane-bound enzyme that catalyzes the reversible reduction of NADP(+) by NADH. This reaction is linked to proton translocation across the membrane. Depending on metabolic conditions, the enzyme may be involved in NADPH generation, e.g., for detoxification of peroxides and/or free radicals and protection from ischemic damage. Nnt exists in most prokaryotes and in animal mitochondria. It is composed of 2-3 subunits in bacteria and of a single polypeptide in mitochondria. An open question is whether Nnt exists in any photosynthetic eukaryotes and if so, to which class it belongs. In the present study it is demonstrated that, by cloning and sequencing cDNA and genomic copies of its NNT gene, an ancient alga, Acetabularia acetabulum (Chlorophyta, Dasycladales), contains a nuclear-encoded Nnt. In contrast to photosynthetic bacteria, this algal Nnt is composed of a single polypeptide of the class found in animal mitochondria. Excluding a poly(A) tail, NNT cDNA from A. acetabulum is 3688 bp long, consists of eight exons and spans 17 kb. The NNT gene from mouse was also characterized. Subsequently, the gene organization of the A. acetabulum NNT was compared to those of the homologous mouse (100 kb and 21 exons) and Caenorhabditis elegans (5.1 kb and 18 exons) genes.     

四川自贡中侏罗世璧山上龙一新种

2001年春,自贡市永安乡村民王新民在自家花园附近的紫红色沙质泥岩里发现一批脊椎动物化石。自贡恐龙博物馆接到报告后,由舒纯康同志前往调查处理,并将这批化石发掘回馆。该化石为一具不完整蛇颈龙类骨架,因其左后肢带骨较完整,有必要对它进行报道。     

Mechanisms of synovial joint and articular cartilage formation: recent advances, but many lingering mysteries

Synovial joints are elegant, critically important, and deceptively simple biomechanical structures. They are comprised of articular cartilage that covers each end of the opposing skeletal elements, synovial fluid that lubricates and nourishes the tissues, ligaments that hold the skeletal elements in check, and a fibrous capsule that insulates the joints from surrounding tissues. Joints also exhibit an exquisite arrays of shapes and sizes, best exemplified by the nearly spherical convex femoral head articulating into a nearly spherical concave hip acetabulum, or a phalangeal joint with two condyles on the distal side articulating in reciprocally-shaped sockets on the opposing proximal side. Though few in number, joint tissues are highly specialized in structure and function. This is illustrated by articular cartilage with its unique extracellular matrix, unique biomechanical resilience, its largely avascular nature, and its ability to persist through life with minimal turnover of its cells and components. The fact that interest in synovial joints has remained unabated for decades is a reflection of their fundamental importance for organism function and quality of life, and for their susceptibility to a variety of acquired and congenital conditions, most importantly arthritis. This has led to many advances in this field that encompass molecular genetics to biomechanics to medicine. Regrettably, what continues to be poorly understood are the mechanisms by which synovial joints actually form in the developing embryo. If available, this information would be not only of indisputable biological interest, but would also have significant biomedical ramifications, particularly in terms of designing novel tissue regeneration or reconstruction therapies. This review focuses on recent advances in understanding the mechanisms of synovial joint formation in the limbs, and places and discusses the information within the context of classic studies and the many mysteries and questions that remain unanswered.     

Entrapment of adult fingers between window glass and seal entry of a motor vehicle side door: an experimental study for investigation of the force at the subjective pain threshold

In modern motor vehicles with automatic power windows, a potential hazard exists for jam events of fingers between the window glass and seal entry. This study determined entrapment forces acting on adult fingers at the subjective maximum pain threshold during entrapment in such windows. The length and the girth of the proximal and distal interphalangeal joints of the triphalangeal fingers of the right hands of 109 participants (60 men, 49 women) were measured; the diameter was calculated from girth, which was assumed to be circular. The automatic power window system of a motor vehicle side door was changed to a mechanical system. During entrapment the force distributed across the four proximal interphalangeal joints (PIPs), and separately on the proximal interphalangeal (iPIP) and then the distal interphalangeal (iDIP) joints of the index finger was measured using a customized force sensor. The maximum bearable entrapment force was 97.2 ± 51.8 N for the PIPs, 43.4 ± 19.9 N for the iPIP, and 36.9 ± 17.8 N for the iDIP. The positive correlation between finger diameter and maximum entrapment force was significant. Particularly with regard to the risk to children's fingers, the 100 N statutory boundary value for closing force of electronic power windows should be reduced.     

Cloverleaf skull associated with generalized bone defects close to asphyxiating thoracic dysplasia

The association of cloverleaf skull and micromelia is reputed. X-ray images of the skull are typical; those of the skeleton are compatible with the thoracic dysplasia reported by Jeune, or with chondro-ectodermic dysplasia: short ribs, horizontal roof of the acetabulum with a rounded median prominence and lateral spurs, deformed long bones with broad metaphyses, absent ossification of the terminal phalanges. The mode of inheritance of the syndrome is probably autosomal recessive. The association reported is undescribed until now, although cloverleaf skull can be associated with other bone deformities. Most often the latter are thanatophoric dwarfism or a syndrome including ankylosis of the elbow joints, occasionally of the knees, club-foot, syndactyly and absent phalanges.     

Evaluating a suitable level of model complexity for finite element analysis of the intact acetabulum

To enable large-scale multi-factorial finite element (FE) studies, the FE models used must be as computationally efficient as is feasible, while maintaining a suitable level of definition. The present study seeks to find an optimum level of model complexity for use in such large-scale studies by investigating which model attributes are most influential over the chosen model outputs of principal stress and strain in the intact acetabulum. A multi-factorial sensitivity study was carried out using 128 FE models, representing combinations of the following variables: bone stiffness distribution, imposed muscle loading, boundary condition location, hip joint contact conditions and patient's bone anatomy. The relative sensitivity of each input factor was analysed, and it was concluded that the optimum level of model definition must include CT-dependent trabecular bone properties and a sliding interface at the hip joint. It was found that it was not essential to describe the ligamentous sacroiliac and pubic symphysis joints; these could be rigidly fixed in space; and for the normal walking load case, muscle forces may be neglected. It was also concluded that a variety of bone anatomies should be included in a multi-factorial analysis if results are to be inferred for a wider population.     

Effects of isoflurane on measurements of delayed lumininescence in Acetabularia acetabulum.

The volatile halogenated methyl ethyl ether, isoflurane, used as an anaesthetic, inhibits actin-based dynamics directly or indirectly in animal cells. In plant cells, most intracellular movements are related to actin pathways. We have used isoflurane in a unicellular alga, Acetabularia acetabulum, to test the dynamics of choloroplast organization. By measuring the delayed luminescence, we found that isoflurane worked efficiently in the unicellular organism and showed dose- and time-course-dependent actin-inhibition patterns. When A. acetabulum was treated with saturated solutions of isoflurane in artificial seawater (defined as 100% isoflurane) for 3 or 6 min, the delayed luminescence (DL) was decreased and was never recovered. In contrast, if treated with 75% diluted isoflurane, the DL was firstly inhibited and then recovered several hours later, and if treated with 50% diluted isoflurane, the change of DL was small. Our work proved that isoflurane can affect actin-related pathways in both animals and plants.     

Regional load bearing of the feline acetabulum

OBJECTIVE: To test if the caudal acetabulum of the cat is unloaded at mid-stance as has been asserted. MATERIALS AND METHODS: A kinematic study of five healthy cats was performed to ascertain the mid-stance angle of the hip joint, and the orientation of the pelvis and femur. Femora and pelves from 10 feline cadavers were loaded at physiological load at the mid-stance angle. Impression material placed within the acetabulum was extruded from areas of load bearing. Digital images before and after loading were used to assess whether three areas of the acetabulum, cranial, central and caudal, were fully, partially or non-load bearing. RESULTS: There was a significant difference in load bearing in the three regions (p < 0.001, Kruskal-Wallis test), with a significant difference in load bearing between the cranial and central thirds (p < 0.001) and the cranial and caudal thirds (p < 0.001) but no difference between the central and caudal thirds of the acetabulum (Mann-Whitney-U test). CONCLUSIONS: The load bearing areas of the feline acetabula are the caudal and central thirds. CLINICAL RELEVANCE: The caudal acetabulum of the cat is loaded, therefore the recommendations for simple fractures being treated conservatively needs to be reconsidered.