Articular Cartilage Thickness of the Humeral Head: An Anatomic Study

Abstract

This study determined the thickness of normal humeral head articular cartilage by anatomic cross section using computer-aided image analysis software. Sixteen adult cadaveric humeral heads were analyzed. Our fi ndings reveal that the thickness of humeral articular cartilage is substantially thinner than articular cartilage found in the knee. The cartilage is thickest in the central portion of the head and becomes progressively thinner towards the periphery. Surgical techniques used to treat pathology in the glenohumeral joint, specifi cally thermal energy or mechanical debridement, may have deleterious effects on the relatively thin humeral articular cartilage.A rticular cartilage thickness has been extensively studied in the knee. 1-7 However, there is a paucity of data regarding the thickness of articular cartilage of the humeral head. Most characterizations of humeral head articular cartilage have been performed using radiographic imaging studies, specifi cally magnetic resonance imaging with and without the use of intraarticular contrast. [8][9][10] The radiographic data obtained in two of these studies were compared to the corresponding data obtained by direct measurement of the articular surface. In both studies, only limited areas of the humeral head were analyzed, and direct measurements of the articular surface were performed by observers using loupe magnifi cation. The diffi culty in accurately imaging the highly spherical humeral head and the substantially thinner articular cartilage found on the hu-meral head as compared to the knee were the reasons given for the inferior results. According to Eckstein 2 , magnetic resonance imaging (MRI) of strongly curved surfaces can overestimate cartilage thickness without appropriate derivations. Soslowsky et al 11 used stereophotogrammetry to defi ne the geometry of the glenohumeral articulation and reported on surface area and cartilage thickness of both the humeral head and the glenoid.The purpose of this study was to determine the thickness of humeral head articular cartilage via anatomic measurements from multiple cross sections of cadaveric humeral heads using computeraided image analysis software. From this data a topographical map of humeral head articular cartilage was developed. This information may serve as a standardization of normal articular cartilage thickness of the humeral head. MATERIALS AND METHODSEighteen adult cadaveric humeri (8 left and 10 right) were obtained through the anatomic gift association at Rush University Medical Center. The age of the specimens ranged from 53 to 91 years. Overlying muscle and soft tissue were sharply dissected away with a scalpel and scissors with care taken to avoid injury to the articular surface. Two right humeral heads were eliminated: one head demonstrated evidence of degenerative changes, and the second head had developed subchondral cysts. Thus, 16 humeral heads were analyzed. Humeral heads were cut at the anatomical neck with a band saw. The heads were then placed in a plastic container and potted in Iso...

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