University O f Basrah Ministry of higher Education
A l-zahraa Me dical College and Scientific Researches
Academic year 2022- 2023
2nd year (S3)
Module: Musculoskeletal system (MSK)
Session No. 9
Lecture: 1
Date: 6th December 2022
The Knee Joint
Module staff:
Dr. Falih Waheed Hashim Dr. Raed Jasim Chasib
Dr. Nawal Mustafa Dr. Rafid Mousa
Dr. Waleed Jwad Dr. Khalil I. Sadiq
Dr. Ahmed Ibrahim Habib Dr. Mohammed Baqir Abbas
Dr. Ahmed Hazim Dahamm
Moore, K.L. and Dalley, A.F. Clinically Oriented Anatomy, 8thEdition. Lipincott Wlliamsand Wilkins, 2018.
Learning Objectives
• Describe the bony surface involved in the knee joint.
• Describe the ligaments associated with joint and their
role in maintaining stability
• Describe the movements of the joint and the major
muscles involved
• Discuss some common conditions affecting
the joint and their investigation (e.g., testing for
ligament damage)
Knee Joint
•Largest & most complex
joint in the body.
•Bones involved:
1.Femur
2.Tibia
3.Patella
* Fibula is not directly
involved in the joint
(proximal tibiofibular joint)
Knee Joint
• between the medial & lateral
Femorotibial condyles of femur & the
corresponding condyles of the
(Hinge joint) tibia.
• Between the patellar surface
Patellofemoral of the femur and articular
(Gliding joint( surface of the patella.
Stability of Joints
The shape of the
bony surfaces means
the joint is relatively
weak and its stability
relies on muscles and
ligaments.
Stability of Joints
• Bony Factors
• Ligamentous factors
• Muscular factors
• Special situations
By fibrocartilage (meniscus)
Extracapsular Ligaments
1. Ligamentum patellae
2. Medial collateral ligaments
3. Lateral collateral ligaments
4. Oblique popliteal ligament
5. Arcuate popliteal ligament
The patellar ligament:
• It is the distal end
of the quadriceps
tendon en route to
its insertion onto
the tibia.
• Support the joint:
anteriorly
Fibular (lateral) collateral ligament:
• Is strong, cord-like,
extends from the
lateral epicondyle of
the femur to the
lateral surface of the
head of the fibula.
• It stabilizes the
joint: Laterally
Tibial (medial) collateral ligament:
• Is weaker, flattened
extends from the medial
femoral epicondyle to the
medial condyle of the
tibia.
• Its middle fibres are
attached to the medial
meniscus.
• It stabilizes the joint:
Medially
Oblique popliteal ligament:
It is a thickening of
the tendon of
semimembranosus,
which strengthens the
posterior aspect of the
knee capsule as does
the Arcuate popliteal
ligament.
Anterior and posterior cruciate ligaments:
Anterior cruciate ligament:
• The weaker cruciate
ligament is attached to the
anterior intercondylar
surface of the tibia and the
lateral condyle of the
femur.
• It prevents femur from
moving Backward on the
tibia
posterior cruciate ligament:
• It the stronger cruciate
ligament.
• Is attached to the
posterior intercondylar
surface of the tibia
below and the medial
condyle of the femur.
• It prevents femur from
moving Foreword on the
tibia
Functions of knee ligaments:
1. The collateral ligaments: prevent excessive
medial or lateral displacement of the joint
2. The anterior cruciate ligament: prevents
hyperextension of the joint and anterior
displacement of the tibia on the femur.
3. The posterior cruciate ligament: prevents
hyperflexion of the knee and excessive
posterior movement of the tibia upon the
femur.
Muscular Factors
• Vitally important:
1. Tendons of quadriceps
muscles
2. V. Medialis: the direction of
insertion of part of it into
the quadriceps tendon
prevent the patella sliding
laterally.
Muscular Factors
Ilio-tibial tract – stabilizes the slightly flexed knee
• Are two fibrocartilaginous
plates (the medial and
lateral menisci).
• The peripheral border is
thick attached to the
capsule while the inner
border is thin & concave
forming a free edge.
• They help to deepen the
articular surface of the
tibia and also act as shock
absorbers.
The medial meniscus:
is C shaped; attached
anteriorly and posteriorly to
the intercondylar areas of
tibia anterior to the
attachment of the cruciate
ligaments.
The medial meniscus:
it is firmly attached to the
tibial (medial) collateral
ligament;
What does this mean?
damage to the tibial
collateral ligament is almost
invariably associated with
tearing of the medial
meniscus.
Lateral meniscus:
Is almost circular, smaller
than the medial and more
movable not attached to
lateral collateral ligament.
Special Situation
Locking of the knee
joint:
• When knee is fully
extended with the
foot on the ground,
as standing upright,
the knee „locks‟.
Locking of the knee joint
• The medial condyle of the
femur is larger than the
lateral,
• a medial rotation of the
femur on the tibia occurs
until the major ligaments
twisted taut effectively
locking the knee into a
rigid structure.
• To flex the knee from full
extension, the popliteus
causes lateral rotation of
the femur (knee unlocks).
Movements of Knee Joint
rotation
rotation
Bursae of Knee Joint
4 bursae are related to the patella:
1. Suprapatellar bursa.
2. Prepatellar bursa
3. Subcutaneous infrapatellar bursa
4. Deep infrapatellar bursa
Each bursa may become inflamed and
swollen (Bursitis).
The suprapatellar bursa:
is an extension of the
synovial cavity of the
knee between the
quadriceps femoris
and the femur.
The suprapatellar bursitis
The prepatellar bursa:
Lies between the
apex of the patella
and the skin.
Superficial infrapatellar
bursa:
Found between the tibial
tuberosity and skin.
Deep infrapatellar bursa:
lies between the patellar
tendon and the tibia.
Bursitis:
Knee INJURIES
Injuries to the knee are
common.
The commonest injury is
ligament strain caused by a
force being applied to the
side of the knee (medial or
lateral) when the foot is
planted firmly on the
ground.
Knee INJURIES
The attachment of the medial
collateral ligament to the
medial meniscus means that a
blow to the lateral side of the
leg can tear both the medial
ligament and the meniscus.
Opening of the joint can also
lead to tearing of the anterior
cruciate ligament resulting in
the “unhappy triad of
injuries”.
Knee INJURIES
Anterior cruciate lig.:
tear can be caused by severe blows to the lateral side
of knee with the joint semiflexed.
Knee INJURIES
Posterior cruciate ligament: can be damaged by
hyperextension or impacts to the upper end of the
tibial tuberosity.
Knee INJURIES
A blow to the flexed
knee may result in
fracture to the patella.
U n i v e rs i t y O f B a s ra h Ministry of higher Education
A l - z a h ra a M e d i c a l C o l l e g e and Scientific Researches
