Skip to main content

Walking on water: load bearing, joint perfusion and osteoarthritis

Published on September 30, 2026   24 min

A selection of talks on Physiology & Anatomy

Please wait while the transcript is being prepared...
0:00
Hello. I'm Michael Beverly, an orthopaedic surgeon. I'd like to tell you something about walking on water, or at least load-bearing, joint perfusion and why you get osteoarthritis.
0:16
Well, we all have a skeleton, and that has a number of functions. For example, producing red cells and the calcium store, but mainly, we use our skeletons for walking about, assisted by joints. Of course, those are beautifully lubricated cartilage ends bathed in a synovial fluid which gives it such a great mechanical advantage. But bone is a living tissue. Each bone has arteries and veins and a blood supply. The problem mainly is with orthopaedic surgeons who believe bone is like wood. You can saw or drill, or plate, or bang a nail down it or even replace the whole joint.
1:01
But I want to alter your thinking about that. Here is a thesis. Bone is a living tissue. It's micro-flexible, and it's perfused with a blood supply. When it's loaded, enormous pressures arise just under the joint surfaces, and that force or pressure is transferred by hydraulic means through the liquid fat under the joint surfaces and onto the shaft of the bone. If you accept that and look for changes in the vessels, you will find they're beautifully modified to cope with this hydraulic or dynamic vascular mechanical system. When that fails, it contributes to osteoarthritis. Well, what do we know about bone circulation?

Quiz available with full talk access. Request Free Trial or Login.

Show
Hide

Walking on water: load bearing, joint perfusion and osteoarthritis

Embed in course/own notes