The Journal of Bone and Joint Surgery, Vol 67, Issue 2 295-302, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Studies of tibial subchondral bone density and its significance
J Noble and K Alexander
We examined the relationships between the density of the subchondral bone
of the proximal end of the tibia and the location and condition of the
overlying articular cartilage and menisci. We took coronal sections of the
tibial plateaus and of the overlying articular cartilage and menisci from
human knee joints that were grossly free of osteoarthritis. The specimens
were examined for the presence of cartilage fibrillation using the
India-ink technique of Meachim. Bone density was determined using the
Quantimet picture-point analyzer. Fibrillation of articular cartilage was
observed only in the articular cartilage that was not covered by meniscus
and lying mesial to it, which supports the concept that the meniscus
confers a protective effect on the articular cartilage. The density of the
bone underlying the meniscus was lower, and was inversely related to the
thickness of the meniscus and directly related to the thickness of the
articular cartilage. In four knees from which the menisci were absent, the
bone density was increased at the periphery. We suggest that there is a
trinitarian relationship between the meniscus, cartilage, and subchondral
bone, in which structural changes in any one of the three causes secondary
pathological adaptive changes in the other two.
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