Contact areas and pressure distributions in the subtalar joint

We investigated how foot position and ankle arthrodesis affect the contact characteristics of the subtalar joint. Nine fresh-frozen specimens of amputated lower legs were used. Pressure-sensitive films were inserted into the anterior and posterior articulation of the subtalar joint. The contact areas and pressure for various foot positions and under axial loads of 600, 1200, and 1800 N were determined based on the gray level of the digitized film. In neutral position and under a 600 N load, the maximum contact pressure in the subtalar joint was 5.13 +/- 1.16 MPa. The contact area (1.18 +/- 0.35 cm2) was only 12.7% of the whole subtalar articulation area (9.31 +/- 0.66 cm2), and the total force (348.5 +/- 41.7 N) transmitted via this contact area was about 58% of the applied load (600 N). Dorsiflexion of the foot increased the contact area and the force transmitted, but decreased the average contact pressure in the subtalar joint, while the reverse occurred in plantar flexion. Eversion increased the subtalar contact stress, whereas inversion up to 10 degrees decreased it. Ankle joint arthrodesis shifted the contact areas in the subtalar joint posteriorly in all inversion/eversion positions. Moreover, total force transmitted through the subtalar joint as well as the contact pressure increased.