Contribution of the cortex to epiphyseal strength: The upper tibia studied in cadavers

Non-destructive measurements of compressive stiffness were carried out on 20 proximal tibial autopsy specimens. The tibial epiphyses were first loaded through a template covering all but the peripheral 2 mm of the subchondral resection surface, then through the whole resection surface, and finally, after removal of the peripheral shell. A slight increase of the stiffness coefficient resulted from peripheral contact. Stiffness increased significantly after removal of the shell, but several potential sources of systematic error in this part of the investigation raise questions as to the validity of this finding. The area-corrected stiffness showed a decrease as a result of peripheral contact; this result indicates that the peripheral rim of bone has a lower area-corrected stiffness than the central bone, a finding which is incompatible with the concept of a true cortical shell at the epiphyseal level.