KNEE JOINT
INTRODUCTION
• Type- Synovial
• Subtype- Condylar variety and freely movable
Articular surfaces-
• The Condyles of Femur
• The Patella
• The condyles of Tibia
It is the largest and most complex joint of the body
• The complexity is due to fusion of 3 joints
1. The lateral femerotibial
2. Medial femerotibial
3. Femeropatellar joints
Ligaments of Knee joint
1. Fibrous capsule
2. Ligamentum patellae
3. Tibial collateral ligament
4. Fibular collateral ligament
5. Oblique popleteal ligament
6. Arcuate popleteal ligament
7. Cruciate ligament
8. Manisci
9. Transverse ligament
1. Fibrous capsule
• It is very thin and is deficient anteriorly, where it is replaced by quadriceps
femoris, patella and ligamentum patellae.
Femoral attachment
• It is attached about of to 1cm beyond the articular margins.
• The attachments are
1. Anteriorly it is deficient.
2. Posteriorly attached to intercondylar line.
3. Laterally it encloses the origin of popliteus
Tibial attachment It is attached about of to 1 cm beyond the articulor margins.
4. Anteriorly it descends along the margins of the condyles to the tibial tuberosity,
where it is deficient .
2. Posteriorly it is attached to intercondylar ridge.
3. Postero laterlly there is a gap behind the lateral condyle for passage of
tendon of the popliteus.
2. Ligamentum Patellae
• This is the central portion of the common tendon
of insertion of the quadriceps femoris .
• It is about 7.5 cm long and 2.5 cm broad.
• It is attached above to the margins and rough
posterior surface of the apex of patella and below
to the smooth upper part of tibial tuberosity.
• it is related to superficial and deep infrapatellar
bursae and to infrapatellar pad of fat.
[Link] /medial collateral ligament
• It is strong ligament
• Superiorly attached to medial epicondyle of
femur just below the adductor tubercle.
• Inferiorly it divides into anterior and posterior
parts
• Anterior or superficial part is about 10 cm long
and 1.25 cm broad.
• Posterior or deep part is short and blends with
the capsule and with the medial meniscus
4. fibular/lateral collateral ligament
• It is strong and cord like ligament
• About 5cm long
• Superiorly attached to lateral epicondyle of
femur just above popliteal groove
• Inferiorly it is embraced by tendon of biceps
femoris.
• And inferiorly attached to head of fibula
infront of its apex.
Ligaments
[Link] popliteal ligament-
• This is an expansion from the tendon of
semimembranosus.
• It runs upwards and laterally, blends with the posterior
surface of the capsule and is attached to the intercondylar
line and lateral condyle of the femur.
[Link] popliteal ligament-
• This is a posterior expansion from the short lateral liament
• It extends backwards from the head of the fibula, arches
over the tendon of popliteus and id attached to the
posterior border of intercondylar area of the tibia.
7. Cruciate ligaments
• These are very thick and strong fibrous bands
• They act as direct bands of union between tibia and femur,
to maintain the anteroposterior stability of knee joint.
• They are two in number
1. Anterior cruciate ligament-
• Begins from anterior part of intercondylar area of tibia
• Runs upwards backwards and laterally
• Attached to posterior part of medial surface of lateral
condyle of femur
• It is taut during extension of knee.
Cruciate ligaments
2. Posterior cruciate ligament-
• Begins from posterior part of intercondylar
area of tibia
• Runs upwards forwards and medially
• Attached to anterior part of lateral surface of
medial condyle of femur
• It is taut during flexion of knee.
8. Menisci
• These are two fibrocartilagenous discs
• Shape- crescent shape
• They deepen the articular surfaces an dpartially divide the joint cavity
into upper and lower compartment.
• Each meniscus has-
2 ends- anterior and posterior attached to tibia and also called as horns
2 borders- the outer border is thick, convex and close to fibrous capsule.
• The inner border is thin concave and free
2 surfaces- upper surface is concave for articulation with femur
• Lower surface is flat and rests on tibia
• Peripheral part is vascular, inner part is avascular
• Medial meniscus is semicircular and lateral is nearly circular.
Functions of menisci
• Help in making articular surfaces more congruent
• Serve as shock absorbers.
• Helps in lubricating the joint cavity
• It guide/regulate the movement of joint
• Divides the joint cavity in to upper and lower
compartment incompletely.
• Serves sensory function of the joint.
9. Transverse ligament- it connects the anterior ends
of medial and lateral menisci.
Bursae
• 12 in number, 4 anterior, 4 lateral, 4medial
• Anterior-
1. Subcutaneous prepatellar barsa
2. Subcutaneous infrapatellar bursa
3. Deep infrapatellar bursa
4. Suprapatellar bursa
• Lateral-
• A bursa deep to lateral head of gastrocnemius
• Between fibular collateral ligament and biceps femoris
• Between fibular collateral ligament and tendon of popliteus
• Between tendon of popliteus and lateral condyle of tibia.
Bursae
• Medial-
1. Bursa deep to medial head of
gastrocnemious
2. Ansarine bursa between tendons of
sartorius,gracilis and semitendinosus
3. A bursa deep to tibial collateral ligament
4. A bursa deep to semimembranosus.
Relations
Anteriorly-
• Anterior bursae, ligamentum patellae
Posteriorly-
• Popliteal vessels, tibial nerve, common peronial nerve
• Gastrocnemius, semitendinosus, semimembranosus, gracilis,
popliteus.
Medially-
• Sartorius, gracilis, semitendinosus
• Great saphanous vein, saphanous nerve
• Semimembranosus
Laterally-
• Biceps femoris, tendon of origin of popliteus.
Blood supply
a. Five Genicular branches of Popliteal artery
b. Descending Genicular branch of femoral artery
c. Descending branch of Lateral Circumflex Femoral
artery.
d. Two Reccurent branches of Anterior Tibial artery
e. The circumflex fibular branch of Posterior Tibial
artery.
Nerve supply
• Femoral, Sciatic and Obturator nerve
Movements
• Flexion- Biceps femoris, Semitendinosus and
Semimembranosus
• Extension- Quadriceps femoris
• Medial rotation of flexed leg- Popliteus,
Semimembranosus, Semitendinosus
• Lateral rotation of flexed leg- Biceps femoris
• Locking- Vastus medialis
• Unlocking- Popliteus
• Note- Locking is a mechanism that allows the knee to
remain in fully extended position without much muscular
effort
Clinical anatomy
• Osteoarthritis- degenerative
• Genuvarum- outward bowing of knees
• Genuvalgum-knees turn inward
• Meniscal tear- due to trama
• ACL and PCL tear
• Collateral ligaments sprain
• Baker’s cyst- a fluid filled cyst over the
posterior aspect of knee.
