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Lateral Medial Genu Valgum Neutral Genu Varum

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Mechanical axis:
Weight bearing line
θ ~ 175°
Passes from the center of the hip
to the center of the ankle

Anatomical axis:
Follows the longitudinal orientation
of the bone

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• Acts as a filler in between the
femoral condyles and the tibial
plateau.
• Increases the interfacing surface
area
• Maintains joint stability by the
wedge effect
• Releases the joint stress
• Absorbs impact load and prevents
bone injury
• Reduces friction under higher load
bearing by releasing water on being
highly compressed
• Prevent capsule, synovial
impingement

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• Ginglymus (hinge)
• Arthodial (pivot, gliding)
• 6 degrees of freedom
–3 rotations
–3 translations

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Rotation:
• Flexion – extension: up to 160° of flexion
• Varus – valgus: 6° – 8° in extension
• Internal – external rotation: 25° – 30° in flexion

Translation:
• Anterior – Posterior: 5 – 10 mm
• Compression: 2 – 5 mm
• Medio – Lateral: 1 – 2 mm

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• Anterior tibial glide persists on the tibia’s medial condyle

because its articular surface is longer in that dimension
than the lateral condyle’s.
• Prolonged anterior glide on the medial side produces
external tibial rotation, the “screw-home” mechanism

LATERAL

Initial 25°: Mainly Roll After Initial 25°: Roll + Glide 4

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• Largest sesamoid bone in the body
• The actual degree of knee flexion • Location: embedded in quadriceps tendon
required to ascend stairs is determined • Function: to increase mechanical leverage of the
not only by the height of the step, but quadriceps
also by the height of the patient.
• For the standard 7" step approximately
65° of flexion will be required.
• In climbing stair , lever arm can be
reduced by leaning forward. Also, in
stair climbing the tibia is maintained
relatively vertical, which diminishes the
anterior subluxation potential of the
femur on the tibia.
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Laterally- lateral retinaculum, vastus lateralis m,
• In standard step 85° of flexion is required. iliotibial tract.
• The tibia is steeply inclined toward the Medially- medial retinaculum and vastus medialis m.
horizontal, bringing the tibial plateaus into Superior- Quadriceps via quadriceps tendon.
an oblique orientation. Inferior- Patellar ligamentum
• The force of body weight will now tend to
sublux the femur anteriorly. This anterior
subluxation potential will be resisted by
the patellofemoral joint reaction force, and
the tension which develops in the
posterior cruciate ligament.

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The knee adduction
moment is a result
of the magnitude of
the ground reaction
force (GRF) times
the distance (i.e.
moment arm) from
the center of
rotation (GRF*LA).

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As the femur presses down on the meniscus during normal loading, the meniscus
deforms radially but is anchored by its anterior and posterior horns (Fant and Fpost).
During loading, tensile, compressive, and shear forces are generated.

A tensile hoop stress (Fcir) results from the radial deformation, while vertical and
horizontal forces (Fv and Fh) result from the femur pressing on the curved superior
surface of the tissue. A radial reaction force (Frad) balances the femoral horizontal force
(Fh). (Athanasiou K.A., Sanchez-Adams J. Engineering of the knee mesiscus. 2009) 6
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Schematic representation of the biomechanical musculoskeletal

knee model used to calculate knee joint loads and muscle forces

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(A) Knee compressive, and (B) Hamstring, (C) Quadriceps, and (D)
Gastrocnemius muscle forces of a complete stance phase of a typical
participant. Note: 1 body weight = 923.1 N (94.1 kg).

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