applied anatomy of knee joint

In contrast, there is no connection between the lateral meniscus and the corresponding collateral ligament (Fig. It is usually regarded as a sesamoid bone, developed in the quadriceps femoris tendon. Superior view of the menisci and their attachments (right knee). The Knee-Joint. Tibio-femoral joint: Modified hinge or condyloid joint, Patello-femoral joint: Sellar or saddle joint, Popliteal gives: superior (medial and lateral), middle, inferior (medial and lateral), Femoral gives: descending branch from profunda, Sciatic nerve, through direct genicular branches, Obturator nerve, through posterior division, Active: Upto 120º with hip extended and upto 140º with hip flexed, Genu valgum or Knock knee: Tibia abducted with respect to femur (> 170º), Genu varum or Bow leg: Tibia adducted with respect to femur (< 170º), Knee Valgus Stress Test (Medial collateral ligament), Knee Varus Stress Test (Lateral collateral ligament), Apley’s Compression Test and Apley’s Distraction Test, Inability to fully extend knee may suggest “bucket-handle” meniscal tear. Nevertheless, the isolated vision of the a … Q angle (Quadriceps angle): is a measure of the axis of pull of the quadriceps tendon and that of the ligament of the patella. internal and external rotation of the tibia in relation to the femur. The ratio of rolling to sliding differs with the degree of flexion or extension, which means that during the first 30° of flexion the movement is almost entirely rolling, whereas at nearly full flexion the condyles slip over the tibial plateau without rolling.2. 1. (a) The knee as a hinge joint: the femoral condyles (twin wheel) in relation to the tibial and patellar surfaces (‘rails’). This problem is resolved by an ingenious arrangement of ligaments, menisci and tendons: the ligaments and menisci provide static stability and the muscles and tendons dynamic stability. 5a. Normal Anatomy and Biomechanics of the Knee Fred Flandry, MD, FACS*w and Gabriel Hommel, MD* Abstract: Functionally, the knee comprises 2 articulations—the patellofemoral and tibiofemoral. separates medial (oval and concave) condyle or facet and lateral (circular and convex) condyle or facet. Knee joint is the largest joint in the body. 82.9). Medical students should be familiar with this anatomy for the prevention of movement impairment. Infection: Knee is the commonest site for spetic arthritis. Movement between the tibial surface and the menisci is limited by the coronary ligaments connecting the outer meniscal borders with the tibial edge (. The knee is made up of four bones. This angle is somewhat greater in females than males. These three bones are covered in articular cartilage which is an extremely hard, smooth substance designed to decrease the friction forces. Therefore, during movement between tibia and femur, distortion of the menisci is inevitable. 2). The coronary ligaments of the medial meniscus are shorter (4–55 mm) and stronger than those of the lateral meniscus (13–20 mm).7 The medial collateral ligament of the knee is attached by its deep fibres to the outer border of the medial meniscus. In nearly all circumstances, the knee works in axial compression under the action of gravity. The superior and inferior surfaces are in contact with the femoral and tibial condyles, respectively, and the peripheral surfaces are adherent to the synovial membrane of the capsule. 82.20). In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). Unlocking: Popliteus externally rotates femur on tibia → Locked ligaments loosen → Hamstrings can then flex knee. The knee joint is fl exed and attached to the bone of the thigh. It additionally allows for a small amount of rotational movement. Cookies and Privacy policy  1b). The inner non-vascularized part receives nutrition through diffusion of synovial fluid.9,10. 3, see Standring, Fig. To measure the extent of internal and external rotation, the knee must therefore be flexed to a right angle. The knee is a huge joint that lets the leg and thigh extend and flex, though it is actually made of two different joints, the tibiofemoral joint and the patellofemoral joint. Their outer third has some blood supply and therefore a slight ability to heal. The distal femur can be compared with a double wheel, in which the medial and lateral condyles are the components and the intercondylar notch the junction between them ( … Knee joint is the largest joint in the body. Joint capsule of the knee , meniscus , ligaments of the knee joint , clinical knee … In lateral (axial) rotation, the menisci will follow exactly the displacement of the femoral condyles, which means that the lateral meniscus will be pushed forwards on the tibia and the medial meniscus will be pulled backwards (, Applied anatomy of the wrist, thumb and hand, Applied anatomy of the temporomandibular joint, Applied anatomy of the lower leg, ankle and foot, Disorders of the inert structures: Ligamentous instability. However, if the anterior and posterior ends are flattened, rotation becomes possible (Fig. Surfaces of the patella: (a) anterior; (b) posterior. This site uses Akismet to reduce spam. Rectus femoris Two joint muscle; most superficial Origin: anterior-inferior iliac spine of the ilium Insertion: top of the patella and patellar ligament to the tibial tuberosity Actions: Flexion of the hip Extension of the knee 2/22/2015Dept of Sports Medicine, AFMC31. In a young child, for example, there may be a posterior displacement of the distal radial epiphysis; in the teenager the clavicle might fracture; in the young adult the scaphoid is commonly fractured; and in the elderly the distal end of the radius is fractured about 1 in. The former is measured by a line drawn from the ASIS (Anterior superior iliac spine) to center of patella. It is separated from the skin by a bursa (prepatellar bursa). In fact this is not so. The aim of this short report is to examine knee joint anatomy and physiology with respect to knee stability. Summary: It is the reversal of locking brought by popliteus muscle. Required fields are marked *. Their outer third has some blood supply and therefore a slight ability to heal. Fig 4 Anterior view of the menisci and their relations with the collateral ligaments: 1, medial meniscus; 2, medial collateral ligament; 3, lateral collateral ligament; 4, lateral meniscus. The inner non-vascularized part receives nutrition through diffusion of synovial fluid. Extension: 0 to 10º above horizontal plane. THE KNEE JOINT COMPLEX CONSISTS OF THE FEMUR, THE TIBIA, THE FIBULA, AND THE PATELLA Articulations The knee joint complex consists of three articulations between femur and the tibia, femur and the patella, tibia and the fibula. The knee joint is a hinge joint during flexion–extension but in a flexed position modifications enable axial rotation around a central pivot. The body of each meniscus is fixed around the femoral condyle and moves with the femur. Description. The tibia or shinbone connects the knee to the ankle. Tibiofemoral – medial and lateral condyles of the femur articulate with the tibial condyles. Slight valgus position: angle between longitudinal axis of femur and tibia is 170º opened laterally. This section is from the book "Applied Anatomy: The Construction Of The Human Body", by Gwilym G. Davis.Also available from Amazon: Applied anatomy: The construction of the human body. 1, lateral collateral ligament; 2, medial collateral ligament; 3, medial coronary ligament; 4, lateral coronary ligament; 5, popliteus tendon; 6, posterior cruciate ligament; 7, semimembranosus tendon. The distal femur can be compared with a double wheel, in which the medial and lateral condyles are the components and the intercondylar notch the junction between them (Fig. Menisci do not contain pain-sensitive structures and are consequently insensitive to trauma. Part 9 Learn how your comment data is processed. Nerve structures and blood vessels: the popliteal fossa. The anteroposterior elevation between the tibial condyles corresponds to the femoral intercondylar notch. It allows knee to remain in the position of full extension as in standing without much muscular effort. This arrangement resembles a twin-wheel rolling on a central rail (, The rounded surfaces of the femoral condyles in relation to the flatter tibial ones might suggest that the former roll during flexion–extension. the knee joint (Fig. Nevertheless, the exposure of the knee to external forces makes it very vulnerable in many occupations and sports. The apex is pointed and gives attachment to the ligamentum patellae. The horns of the medial meniscus are further apart than those of the lateral, which makes the former nearly semilunar and the latter almost circular. b. Fig 2 Surfaces of the patella: (a) anterior; (b) posterior. 1a). The knee is responsible for joining together the leg and the thigh. The knee is also the primary support for the body when in a kneeling position. The clinical anatomy of several pain syndromes of the knee is herein discussed. First, the large spherical head of the humerus articulates against the small shallow glenoid fossa of the scapula (only 25–30% of the humeral head is covered by the glenoid surface). Like the shoulder, the knee is a joint. The inner sides of the menisci, attached by their horns to the tibial plateau, move with the tibia. It is made up of two joints, the tibiofemoral joint (between the tibia and the femur), and the patellofemoral joint (between the patella and the femur). Locking: Full extension → Taut anterior cruciate → No further symmetrical extension → Medial femoral condyle moves back – lateral condyle moves forward → Femur internally rotates on tibia on axis of anterior cruciate ligament → Medial/lateral collateral and oblique popliteal ligaments tighten → Tensor fascia lata and gluteus maximus tighten iliotibial tract → Knee hyperextends and locks. Knee joint (Articulatio genu) The knee joint is a synovial joint that connects three bones; the femur, tibia and patella.It is a complex hinge joint composed of two articulations; the tibiofemoral joint and patellofemoral joint.The tibiofemoral joint is an articulation between the tibia and the femur, while the patellofemoral joint is an articulation between the patella and the femur. Knee joint stability requires the integration of a complex set of anatomical structures and physiological mechanism. During flexion, the femoral condyles roll backwards and slide forwards on the tibia, whereas during extension they roll forwards and slide backwards (see, The knee joint is thus primarily a hinge, with the wheel-shaped surfaces of the femoral condyles gliding and rolling in a twin set of concave curved gutters: the tibial and patellar surfaces. The remaining middle part of the eminence, forming the ‘intercondylar spines’, is then the central pivot about which the movements of axial rotation occur. Fibrous capsule of knee joint is a complex structure which is made up by a collection of adjacent ligaments. 3).8. Menisci do not contain pain-sensitive structures and are consequently insensitive to trauma. Of Locking brought by Popliteus muscle opened laterally the latter is determined a! The structure of the movement allowed by the menisci is limited by the knee joins the thigh posteriorly and extension. Flat, triangular bone, developed in the body when in a flexed position modifications enable axial rotation a! To examine knee joint is two curved ‘ gutters ’, separated by an applied anatomy of knee joint. Is called a hinge joint, which permits flexion and extension as well as slight internal and external of! Your email address will not be published knee sagittal cross sectional anatomy tool is absolutely free to use (! 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