Influences of mechanical stress on prenatal and postnatal skeletal development

A new theory is introduced to describe some of the influences of mechanical stresses on chondroosseous biology. It is proposed that degeneration and ossification is a normal process for all cartilage in the appendicular skeleton, which is (1) accelerated by intermittently applied shear stresses (or strain energy), and (2) inhibited or prevented by intermittently applied hydrostatic pressure. These concepts were applied using finite element computer models in an effort to predict the ossification pattern of the prenatal and postnatal femoral anlage. The theoretical calculations successfully predicted the key features of skeletal morphogenesis including the development of (1) the primary ossification site, (2) a tubular diaphysis and marrow cavity, (3) metaphyseal and epiphyseal trabecular bone, (4) the location and geometry of the growth plate, (5) the appearance and location of the secondary ossific nucleus, and (6) the existence and thickness distribution of articular cartilage. The results suggest that degenerative joint disease in immobilized or non-load-bearing mature joints may be a manifestation of the final stage in the ossification of the anlage. In nonfunctional joints, the absence or reduction of intermittent hydrostatic pressure in the articular cartilage permits cartilage degeneration and the progressive advance of the ossification front toward the joint surface until the articular cartilage has been ossified.