Contact areas and pressure distribution on the proximal articular surface of the proximal phalanx under sagittal plane loading

The objective of this study was to map topographically contact areas and pressure distributions on the proximal articular surface (PAS) of the proximal phalanx (PI) under various clinically relevant loading conditions. Left and right forelimbs of 13 mature horses were transected halfway down the radius and loaded in a position mimicking the weightbearing attitude close to the midstance phase. Five loads were used which corresponded with loads that can be expected in different gaits or during athletic performance (stance: 1800 N, walk: 3600 N, trot: 5400 N, gallop: 10,500 N and jumping: 12,000 N). Contact areas and pressure distributions at the PAS of PI were determined using a methylene blue dye staining technique and 2 pressure sensitive films (low pressure: range 2.5-10 MPa and medium pressure: range 10-50 MPa). The contact area of PI was positively correlated (r = 0.86; P<0.01) with the applied load. The contact area increased from 63% at 1800 N to 95% at 12,000 N and gradually shifted to include more of the edges of the articular surface, but especially the dorsal articular margin of PI. Pressure distribution patterns were similar under the different loading conditions. Pressure was less at the palmar margin and in the central depression and highest at the dorsal articular margin. With increasing load, the highest peak pressures were measured at sites of the dorsal articular margin that are not loaded in the standing or walking horse. The results of this study suggest that the frequent occurrence of osteochondral lesions at the dorsal articular margin of PI is caused by the combination of the intermittent character and the high absolute values of loads at this site as they occur during athletic performance.