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Most students of articular mechanics consider impact loads to be compressive forces that are borne by an intraosseous, trabecular scaffold. The possible role of marrow fat, which comprises about 75% of the structure, is generally ignored, and the potential contribution of type 1 collagen, the prototypic tensile protein, is not considered. Here, I question the evidence underlying these omissions and reject the conclusion of exclusive trabecular compression. Instead, I suggest that impact loading pressurizes the fat in subchondral compartments, and those pressures stretch the elastic trabecular walls, which are thereby subjected to tensile loading. The load-driven pressure pulses then diminish as they pass from each compartment to its adjoining neighbours. The resulting pressure gradient distributes the burden throughout the subchondrium, stores energy for ensuing recovery and subjects individual trabeculae only to the net pressure differences between adjacent compartments.

Marrow fat may distribute the energy of impact loading throughout subchondral bone