Regional Distribution of Articular Cartilage Thickness in the Elbow Joint: A 3-Dimensional Study in Elderly Humans.

Abstract

Background:During elbow procedures, reconstruction of the joint (including the articular cartilage) is important in order to restore elbow function; however, the regional distribution of elbow cartilage is not completely understood. The purpose of the present study was to investigate the 3-dimensional (3-D) distribution patterns of cartilage thickness of elbow bones (including the distal part of the humerus, proximal part of the ulna, and radial head) in order to elucidate the morphological relationship among them.Methods:Two 3-D surface models were created with use of a laser scanner: (1) a cartilage-bone model based on 20 elderly cadaveric elbows exhibiting normal cartilaginous conditions and (2) a bone model that was created after dissolving the cartilage. The 2 models were superimposed, and cartilage thickness was measured as the interval distance on the articular surface. Measurements were made at categorized anatomical points of the individual bones, and 3-D distributions on the entire articular surface were analyzed. The spatial relationship among individual bones was also assessed.Results:In the distal part of the humerus, the cartilage was thickest in the intermediate region between the capitellum and the trochlea (mean [and standard deviation], 1.27 ± 0.17 mm); in the proximal part of the ulna, it was thickest at the anterolateral edge of the coronoid (2.20 ± 0.39 mm) and the anteroproximal edge of the proximal sigmoid notch (2.49 ± 0.55 mm); and in the radial head, it was thickest at the articular zone on the rim circumference within the dish (1.10 ± 0.17 mm) and on the proximal circumference around the side (1.02 ± 0.17 mm) (p < 0.001 for all). These thicker cartilage regions gathered on the joint center, facing each other.Conclusions:The present study demonstrated regional variations in elbow cartilage thickness. The combined findings in individual bones showed “cartilage gathering” at the center of the elbow joint, which we believe to be a novel anatomical finding.Clinical Relevance:An enhanced understanding of elbow cartilage geometry will provide additional insights into elbow procedures in elderly individuals, such as hemiarthroplasties, in which anatomical contours could help to restore normal joint function and improve postoperative outcomes.