This paper describes the results of loading experiments carried out on human hip joints. The unloaded surfaces of the femoral head and the acetabulum are slightly incongruous. The location and magnitude of the contact areas between the surfaces therefore depend on the magnitude and direction of the applied load. The contact areas were determined experimentally for a variety of loads typical of normal walking. Two distinct contact areas were found on the anterior and posterior aspects of the acetabulum at light loads, gradually merging with increasing load until, at a certain transition load, the dome of the acetabulum comes into contact and contact is then complete. The value of the transition load depends on the rate of loading, due to creep of the cartilage, and was found to vary from 50 per cent of body weight in young specimens to 25 per cent of body weight for elderly specimens for rates of loading typical of normal walking. Thus, the dome of the acetabulum is out of contact for a substantial portion of the swing phase of normal walking.
The analysis of a much simplified model of the hip joint is presented. The dependence of contact area on load is demonstrated, but also a method of determining the transition load for complete contact from the load/deflection relation for the hip is suggested. The values of the transition load quoted above were obtained by this method. The analysis further indicates that the distribution of pressure between the articular surfaces depends critically on the distribution of cartilage thickness throughout the joint. It is suggested that the distribution of cartilage thickness is such as to lead to a state of uniform pressure at the upper end of the physiological load range. Some experimental evidence is presented in support of this suggestion.
It is concluded that the function of joint incongruity is to allow the articular surfaces to come out of contact at light loads so that the cartilage may be exposed to synovial fluid for the purposes of nutrition and lubrication. At large loads, the distribution of cartilage thickness ensures that a state of hydrostatic pressure is achieved in order that cartilage, with a large fluid content, may transmit large pressures without flow and consequent loss of its integrity.