Pressure-volume ratio in human cadaver hip joints

Abstract

In postmortem examinations 26 hip joints of 23 adult individuals were filled with Ringer's solution in order to furnish data on the relationship between intra-articular pressure, capsular content, and joint position. A tube system was connected to an 18-gauge needle and to a pressure transducer. After instillation of 2.5, 5.0, 7.5, and 10.0 ml of Ringer's solution, intra-articular pressure was recorded in six different joint positions (extension, 45 degrees and 90 degrees flexion, 40 degrees internal and 40 degrees external rotation, and 45 degrees abduction in extension). Intra-articular pressure depends mainly on the position of the joint, with highest values in external and internal rotation and lowest values in 45 degrees flexion. In this last position, the pressure was zero in two of four cases after injection of 10 ml, whereas with external rotation and instillation of 2.5 ml almost 60 kPa was recorded. In extension and after filling with 10 ml the pressure exceeded the level of normal systolic blood pressure in all cases. Under pathologic conditions intra-articular pressure of the hip joint can rise well above arterial pressure and thus eventually compromise vascular supply to the femoral head, even in the presence of only minimal intra-articular effusion.

Percutaneous pinning after prolonged skeletal traction with the hip in a flexed position for unstable slipped capital femoral epiphysis

“…The human cadaver study indicated that intra-articular pressure of the hip joint depended mainly on the position of the joint, and it showed the lowest in 45 degrees of flexion. [16] We believe that gradual traction with the affected hip in a flexed position of 45 degrees contributed to prevention of occurrence of AVN by reducing intra-articular pressure in the current study.…”

Intracapsular hip pressures in a porcine model

“…The relationship between intracapsular hip pressure and volume has been evaluated before [3,4,8,9,13] with the most recent attention focused by Yen et al [14] on the relationship of hip volume, position, and pressure. Our methodology used a modification of the approach Although the previous study has outlined an intracapsular pressure-volume relationship, these studies cannot possibly be extrapolated to immature nonarthritic atraumatic hips.…”

“…Similarly, Crawfurd et al [3] reported a rise in intracapsular pressure associated with hemarthrosis in a series of subcapital fractures of the femur. However, the study performed by Schwarz et al [13] did not focus on young, non-arthritic hips whereas the study performed by Crawfurd et al was more specific to femoral neck fractures and the effects on intracapsular hip pressures. Until recently, there was a dearth of evidence regarding the nature of the intracapsular pressure-volume relationship and whether hip position impacts this relationship.…”

“…An early study performed by Schwarz et al [13] in cadaveric human hips showed a rise in hip intracapsular pressure with successive injections of Ringer's solution. Similarly, Crawfurd et al [3] reported a rise in intracapsular pressure associated with hemarthrosis in a series of subcapital fractures of the femur.…”

Aktuelles zum Morbus Perthes

“…Im Tierexperiment konnte gezeigt werden, dass durcheine Erhöhung desintraartikulä-renD ruckse ine Ischämie ähnlich dem M. Pertheserzeugt werdenkann, wobeider Drucks tark stellungsabhängig ist -d ie höchsten Drücke zeigens ichi nm aximaler Innen-oderAußenrotation -die niedrigsten bei45°Flexion (50,54).…”