Knee Joint
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Transcript of Knee Joint
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KNEE JOINT
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Knee Joint (Hinge Joint)It is the largest & one of the most complex joint of
the body. It consists of 3 joints in single synovial cavity.
Bones involved: Femur, tibia & Patella1- Laterally- tibiofemoral joint, between the lateral
condyle of the femur, lateral meniscus & lateral condyle of the tibia (modified hinge)
2- Medially- 2nd tibiofemoral joint, between the medial condyle of the femur, medial meniscus & medial condyle of the tibia (modified hinge)
3- An intermediate patellofemoral joint- between the patella & patellar surface of the femur (planar joint)
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Bones of the Knee
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ARTICULATION
Above> Rounded condyles of femurBelow>Condyles of tibia & their
cartilaginous menisciFront>Articulation between lower end of
femur & patella.Articular surfaces of femur, tibia & patella
are covered with “Hyaline-Cartilage”
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TYPE
Forms of 2 types of joint:
1-Synovial Hindge Joint: B/w Femur & Tibia.2-Synovial Plane Joint: B/w Patella &
Femur.
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CAPSULE
Attached to margins of ariticular surfaces & surrounds the sides & posterior aspect of joint.
SUPRAPATELLAR BURSA: The capsule is absent at
the front allowing synovial membrane to pouch upward beneath the quadriceps tendon this is called Suprapatellar bursa.
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Capsule
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MUSCLES STRENGTHENING THE CAPSULEOn each sides of Patella, capsule is
strengthened by expansion from tendons of Vastus Lateralis &Medialis.
Behind the joint capsule is strengthened by expansion of Semimembrensus called Oblique- Popliteal -ligament.
An opening in capsule behind lateral tibial condyle permits tendon of popliteus to emerge.
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LIGAMENTS
LIGAMENTS
EXTRACAPSULAR LIGAMENTS
INTRACAPSULARLIGAMENTS
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EXTRACAPSULAR LIGAMENT(outside the capsule)
EXTRACAPSULAR LIGAMENTS
LIGAMNETUM -PATELA
LATERAL -COLLATERAL LIG
MEDIAL-COLLATERAL LIG
OBLIQUE-POPLITEAL
LIG
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continuation…1-Ligamentum patella: Is a continuation of
central portion of common tendon of quadricep-femoris.
Attached ABOVE> to lower border of patella, BELOW>to tuberosity of tibia.
2-Lateral-collateral lig: Cord-like, attached above to the lateral condyle of femur & below to head of fibula. prevents the knee from various forces. This ligament can be injured by blows to the medial side of the knee. Does not occur frequently.
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Pes Anserine
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Continuation..
3-Medial collateral lig: Flat-band, attached ABOVE to medial condyle of femur & BELOW to medial surface of shaft of tibia. It is firmly attached to edges of medial-meniscus. Prevents the knee from valgus forces. Often injured by blows to the lateral side of the knee.
4-Oblique-popliteal lig:It is a tendons expansion derived from semimembrnosous.It strengthens the posterior aspect of capsule.
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Posterior Capsule
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INTRACAPSULAR LIGAMENT(Inside the capsule)Consists of CRUCIATE LIGAMENTS i.e.Anterior cuciate ligament & Posterior cruciate
ligament. these are the strong intracapsular ligament that cross each other within the joint cavity.
Anterior-cruciate-lig: Is attached to anterior intercondylar area of tibia & passes upward,backward & laterally to be attached to posterior part of medial surface of lateral femoral condyle. In short>It attaches to the tibia anteriorly and the femur posteriorly.
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Continuation…FUNCTION: when the knee joint if flexed it
prevents the tibia in moving forward or pulled anteriorly, posterior displacement of femur on tibia ,Helps maintain rotatory stability.
Posterior cruciate lig:Attached to posterior intercondylar area of tibia
& passes a upward, forward & medially to be attached anteriolaterally on medial condyle of femur. in short> It attaches anteriorly to the femur and posteriorly to the tibia. prevents the tibia from moving posteriorly.
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KNEE LIGAMENTS AND CARTILAGE
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MENISCIC-shaped sheets of fibrocartilage.the peripheralborder is thick & attached to capsule. inner borderis thin & concave & form free edges. upper
surfaceis in contact in condyles of femur& lower surface
incontact with condyles of tibia.Functions:
1. Stabilization2. Shock absorption3. Lubrication
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MEDIAL MENISCUSBroader in front, most frequently injuredThe medial meniscus is “C” shaped.Attached to the medial collateral ligament.
Anterior
Posterior
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MEDIAL MENISCUS
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LATERAL MENISCUSThe lateral meniscus is “O” shaped.Not attached to the lateral collateral
ligament.
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LATERAL MENISCUS
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SYNOVIAL MEMBRANE
Lines the capsule & attached to margins of articular surfaces. On the front & above the joint forms Suprapatellar Bursa, it is held in position by attachment of Vastus intermedius called articularis Genus muscle. On back of joint Popliteal Bursa. A bursa interposed b/w medial head of gastrocnemius & medial condyle of femur & sememembrinosuos is Semimembrosus Bursa.
S.M is reflected forward from posterior part of capsule around the front of cruciate ligaments. as a result cruciate ligaments lie behind the syn.cavity & are not bathed in synovial fluid.
In anterior part of joint S.M is reflected backward from posterior surface of ligamentum patella to form Infrapatellar-Folds,the free borders of folds are termed as Alar –folds.
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Menisci
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Meniscal Attachments
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BURSAE
Numerous bursae are reflected. They are found wherever skin, muscle or tendon rubs against bone.
4 are at front of joint & 6 are at behind the joint.
Suprapatellar bursae,popliteal bursa always communicate with joint &semimembrinosus bursa may communicate with joint.
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CONTINUATION…
Anterior Bursae:
1-suprapatellar Bursae: Lies beneath quadriceps. communicate with
joint cavity. 2-Patellar Bursae: lies in subcutaneous tissues b/w skin & front of
lower half of patella & upper part of ligamentum patella. 3-Superficial infrapatellar Bursae: lies in subcutaneous tissues b/w
skin & front of lower part of ligamentum patella. 4-Deep infrepatellar Bursae: lies b/w ligamentum patella & tibia.
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Bursa
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CONTINUATION…
Posterior Bursae: 1-Popliteal Bursae: Found in association with tendon of popliteus &
communicate with joint cavity.
2-semimbranosus Bursae: Found related to insertion of
semimbranosus & may communicate with joint cavity.
Remaining 4 Bursae are found related to tendon of insertion of bicep femoris,tendonn of sartorius,gracilis & semitendonosus as they pass to their insertion on tibia,beneath lateral head of origin of gastrocenmius & beneath medial head of origin of gastrocnmius.
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Nerve supply
FEMORAL NERVEOBTURATOR NERVETIBIAL NERVECOMMON PERONEAL NERVE
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MOVEMENTS OF THE KNEE
FLEXION: performed by: bicep femoris, semimbranosus semitendonosus. Assisted by : Gracilis Sartorius Popliteus Flexion is limited by contact of back of leg with thigh. Extension: performed by: Quadricep femoris Limited by tension of all major ligaments of joint.
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Knee Flexion
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Knee Extension
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CONTINUATION…
Medial rotation: performed by:SartoriusGracilisSemitendonosus
Lateral rotation:Performed by:Bicep femoris
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RELATIONS
Anteriorly: Prepatellar BursaePosteriorly: popliteal vessels,tibial &
commonperoneal nerves,lymphnodes & muscles forming boundaries of popliteal fossa.
Medially:sartorius,Gracilis & semitendonsus.
Laterally: Bicep femoris,common peroneal nerve.
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Patella
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Patella
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