Sacral and iliac articular cartilage thickness and cellularity: Relationship to subchondral bone end-plate thickness and cancellous bone density

Abstract

Objectives. To measure the thickness and cellularity of adult human sacral and iliac articular cartilages and the thickness and density of the subchondral bones. Methods. The right sacroiliac joints of 15 adult patients were examined post-mortem. HOME (Highly Optimized Microscope Environment) microscopy was used to measure articular cartilage and subchondral bone end-plate thickness. Conventional morphometric techniques were employed to estimate cartilage cellularity and cancellous bone density. Results. Sacral articular cartilage was thicker than iliac (1.81 vs 0.80 mm, P < 0.001). Iliac cartilage cell density in all zones was higher than sacral. The overall mean was 31.19 × 10-3 vs 23.23 × 10-3/mm3, P < 0.001. Superficial zones contained more cells than middle and deep zones but there were large differences between the cell numbers of the middle and deep zones of both sacral and iliac cartilages. Iliac subchondral bone end-plates were thicker than sacral (0.36 vs 0.23 mm, P < 0.001). The thickness of these plates was related inversely to that of the overlying articular cartilages. Iliac subchondral cancellous bone was twice as dense as sacral (22.07 vs 12.05%, P < 0.001), a ratio recognized anteriorly, centrally and posteriorly. Conclusions. Adult human sacral cartilage is thick and of low cell density. It rests upon a thin bone end-plate supported by porous, cancellous bone. Iliac cartilage and bone display the converse proportions. The identification of these variables may assist understanding of normal sacroiliac joint function and the interpretation of tissue changes in the spondylarthropathies.