Effect of foot balance on the intra-articular pressure in the distal interphalangeal joint in vitro.
Authors: Viitanen, Wilson, McGuigan, Rogers, May
Journal: Equine veterinary journal
Summary
# Editorial Summary: Effect of Foot Balance on DIP Joint Pressure Joint pressure elevation is recognised as a driver of osteoarthritis progression, yet little was known about how farriery and trimming decisions directly affect the distal interphalangeal joint (DIP). Viitanen and colleagues loaded twelve equine forelimbs in a hydraulic jig whilst measuring intra-articular DIP pressures under various foot balance scenarios, simultaneously casting the joints under load to map pressure distribution across the articular surface. Heel elevation of just 5 degrees significantly increased DIP pressure; when contrast medium was introduced to simulate a joint with mild effusion, this effect became even more pronounced, whereas heel lowering reduced pressure accordingly. Lateromedial imbalance similarly concentrated pressure toward the elevated side, with contact shifting from dorsal (heel-up position) to palmar (low-heel position) regions depending on trim. These findings provide biomechanical evidence that foot imbalance—whether from trimming or therapeutic shoeing—alters both the magnitude and location of loading within the DIP joint, suggesting that subtle deviations from balance may pose cumulative risks to joint longevity and supporting the pursuit of optimal foot conformation as foundational to lameness prevention.
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Practical Takeaways
- •Maintain balanced foot geometry during trimming and shoeing to minimize detrimental DIP joint pressures; heel elevation should be avoided or minimized unless therapeutically indicated
- •Small angular deviations (5 degrees) in foot balance have measurable mechanical consequences on joint loading—precision in hoof care matters for long-term joint health
- •Recognize that elevated heels, commonly applied for therapeutic purposes, may compromise DIP joint viability over time and warrant careful re-evaluation of necessity
Key Findings
- •Heel elevation by 5 degrees significantly increased intra-articular DIP pressure compared to balanced foot position
- •Heel up position concentrated articular contact on dorsal aspect; toe up position on palmar aspect; and lateromedial imbalance shifted contact towards elevated side
- •Contrast medium injection amplified the pressure-increasing effect of heel elevation and showed heel lowering decreased DIP pressure
- •Foot imbalance from trimming and shoeing directly alters intra-articular pressure distribution and contact area in the DIP joint