applied anatomy of knee joint

During flexion–extension, the knee acts as a hinge joint, whereby the articular surfaces of the femur roll (and glide) over the tibial surface. Like the shoulder, the knee is a joint. 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. 82.20). Movement between the tibial surface and the menisci is limited by the coronary ligaments connecting the outer meniscal borders with the tibial edge (. 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. If the surfaces of the tibial condyles are projected anteriorly, they coincide with the articular surface of the patella which corresponds to, and is almost congruent with, the anterior surfaces of the femoral condyles. Knee joint anatomy, type of joint, articular surfaces, capsule and synovial membrane, movements, locking and unlocking of knee joint, applied anatomy Medical students should be familiar with this anatomy for the prevention of movement impairment. 2). Below the articular surface is a rough, convex, non-articular area, the lower half of which gives attachment to the ligamentum patellae; the upper half is separated from the head of the tibia by adipose tissue. Various nerves and blood vessels supply the muscles and bones of the k… 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. Menisci do not contain pain-sensitive structures and are consequently insensitive to trauma. Terms and conditions  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). Accessory or “bipartite” patella: may represent failure of fusion of the superolateral corner of the patella and is commonly confused with patellar fractures. It allows knee to remain in the position of full extension as in standing without much muscular effort. The knee is a complex joint that flexes, extends, and twists slightly from side to side. The tibia, femur, and patella, all are covered with a smooth layer of cartilage (see below) where they contact each other at th… 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 instability has been the focus of large number of studies over the last decade; however, a high incidence rate of injury still exists. Buy Membership for Orthopaedics Category to continue reading. Menisci do not contain pain-sensitive structures and are consequently insensitive to trauma. Tibiofemoral – medial and lateral condyles of the femur articulate with the tibial condyles. In nearly all circumstances, the knee works in axial compression under the action of gravity. The clinical anatomy of several pain syndromes of the knee is herein discussed. 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. 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. It is the largest joint in the human body. The aim of this short report is to examine knee joint anatomy and physiology with respect to knee stability. 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. 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In fact this is not so. The anterior and posterior horns are anchored to the tibial condyle in the anterior and posterior intercondylar fossae, respectively. Its convex The inner sides of the menisci, attached by their horns to the tibial plateau, move with the tibia. 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. The patella serves to protect the front of the joint and increases the leverage of the quadriceps femoris by making it act at a greater angle. The latter is determined by a line drawn from the tibial tuberosity to the center of the patella. Because the horns of the lateral meniscus are attached closer together and its body is more mobile, distortion is more marked in it. There are two menisci in the space between the femoral and tibial condyles. A Q angle much greater than normal means the patella will track in a lateral direction rubbing against the lateral femoral condyle causing Patella pain. 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 patella (kneecap) is the small bone in front of the knee and rides on the knee joint as the knee … Knee joint is the largest joint in the body. Again, the knee joint is a hingetype joint. These syndromes a … Clinical anatomy of the knee The main movement of the knee is flexion–extension; secondary movement – internal and external rotations of the tibia in relation to the femur – is possible only when the knee is flexed. Save my name, email, and website in this browser for the next time I comment. Movement between the tibial surface and the menisci is limited by the coronary ligaments connecting the outer meniscal borders with the tibial edge (Fig. The medial condyle extends a little more distally than the lateral. It is usually regarded as a sesamoid bone, developed in the quadriceps femoris tendon. 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. Nerve structures and blood vessels: the popliteal fossa. Type of joint: Compound joint. The greater prominence of the lateral femoral condyle prevents the patella from sliding laterally. 2. 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. The anteroposterior elevation between the tibial condyles corresponds to the femoral intercondylar notch. Required fields are marked *. separates anterior and posterior cruciate ligaments, Styloid process of head: attachment for fibular collateral ligament and biceps tendon. To measure the extent of internal and external rotation, the knee must therefore be flexed to a right angle. Summary: Locking occurs as a result of internal rotation of femur during last stage of extension and is produced by quadriceps femoris. Anteroposterior (AP) and lateral views are essential in the diagnosis of knee disorders. 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. internal and external rotation of the tibia in relation to the femur. The femur or thighbone is the bone connecting the hip to the knee. The medial and lateral borders are thinner and give attachment to those portions of the quadriceps femoris, which are derived from the vasti lateralis and medialis. 1a). Degenerative diseases: Knee is the commonest site for osteoarthritis. Summary: It is the reversal of locking brought by popliteus muscle. The menisci correct the lack of congruence between the articular surfaces of tibia and femur, increase the area of contact and improve weight distribution and shock absorption.3–6 They also help to guide and coordinate knee motion, making them very important stabilizers of the knee. Comment policy  The joint. Knee: Anatomy and PhysiologyThe knee joint is an intricate mechanism that functions as a hinge in the creation of all motion in the legs, as well as assisting in the provision of support by the legs to carry the mass of the upper body. During flexion of the knee, the body of the meniscus moves posteriorly and during extension it moves anteriorly. This may reveal subtle joint space narrowing if osteoarthritis is present. Were the knee to be only as so far described – a hinge joint with a long tibial intercondylar eminence gliding between the two femoral condyles – rotation would be precluded. They are crescent-shaped lamellae, each with an anterior and a posterior horn, and are triangular in cross section. Therefore, during movement between tibia and femur, distortion of the menisci is inevitable. The condyles are convex in both planes. However, if the anterior and posterior ends are flattened, rotation becomes possible (Fig. The menisci correct the lack of congruence between the articular surfaces of tibia and femur, increase the area of contact and improve weight distribution and shock absorption. Slight valgus position: angle between longitudinal axis of femur and tibia is 170º opened laterally. There are three bones that come together at the knee joint. The knee joint is the largest joint in the body and connects the thigh with the lower leg. These anatomical differences between the medial and the lateral meniscus may explain the lesser mobility and the greater vulnerability of the former (see Fig. Fig 2 Surfaces of the patella: (a) anterior; (b) posterior. The joint surfaces are lined with hyaline cartilage and are enclosed within a single joint cavity. The tibia or shinbone connects the knee to the ankle. The apex is pointed and gives attachment to the ligamentum patellae. APPLIED ANATOMY OF KNEE -Dr Anurag Ranga 2. Cookies and Privacy policy  However, while this is a satisfactory concept in terms of flexion and extension, in reality the situation is more complex because the knee allows not only gliding and rotation around a horizontal axis but also rotation through a vertical axis, i.e. Normal Anatomy of the Knee Joint web based movie. 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