The line of action in the tibia during axial compression of the leg

Compression of the leg induces bending in the tibia, which can lead to tensile failure of the bone in the midshaft. The purpose of this study was to determine the orientation of the compressive load vector in the human tibia. Five cadaveric lower extremities were instrumented with in situ 6-axis tibial and fibular load cells and subjected to quasistatic axial leg compression tests in two knee positions and nine ankle positions. For each test, the location and angle of the line of action were calculated at the tibial midshaft. The line of action was extended to the bone ends in order to determine the locations of the effective centers of pressure on the tibial plafond and tibial plateau. The effective center of pressure on the tibial plafond consistently migrated anteriorly in dorsiflexion, laterally in eversion, posteriorly in plantarflexion, and medially in inversion. An opposite pattern was observed on the tibial plateau. When the knee was flexed, the effective center of pressure was generally isolated to a small area in the posterior portion of the medial tibial condyle. The percentage of the axial load borne by the fibula varied from -8% to 19%, and was related to the inversion/eversion angle of the ankle (p<0.02), as well as the distance between the fibula and the axial load path at the midshaft (p<0.001). The line of action through the tibia appeared to follow the external load path to the extent allowed by the available joint contact surfaces.