[Areas of contact in human humero-ulnar joints as a function of pressure, their connection through subchondral mineralization and joint surface morphology of the incisura trochlearis].

Evaluation of the stress distribution in joints can be obtained directly from contact areas and pressure forces, and also indirectly from the functional adaptation of the connective tissues. Therefore 8 human humero-ulnar joints, fixed in formalin, were examined for size and position of contact areas (polyether casting/Vidas image analyser) and their dependence upon the joint forces (Zwick material testing machine). The distribution of subchondral mineralisation was assessed, using CT osteoabsorptiometry. Depending on the joint force, the contact areas increase from about 10% of the total surface (20 N) to approximately 60% (1280 N). With weak forces they are localised ventrally and dorsally in the joint, with more powerful forces they run together centrally. With a divided articular surface they join at about 160-640 N, with a continuous surface, at about 40-80 N. Divided joint surfaces show a bicentric mineralisation pattern of the subchondral bone with ventral and dorsal maxima. Continuous surfaces, on the other hand, usually show central maxima. Both the mineralisation pattern and the position of the contact areas suggest a physiological incongruity of the humero-ulnar joint surfaces, which vanishes with increasing pressure due to viscoelastic deformation of articular cartilage and subchondral bone. More marked incongruity is postulated for the divided surfaces than for the others. The consequent peripheral transmission of pressure seems to involve a functional principle, which, present in several human joints, leads to both optimal distribution of the stress and better nutrition of the articular cartilage.