It is a compound & complex synovial joint.
Functionally, the knee joint is a condylar & modified hinge
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joint.
1. Transverse axis of movement is not fixed, & moves
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forward during extension & translates backward inflexion;
2. Along with extension & flexion, there is a conjunct
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rotation of femur on tibia(or vice versa) around a
more or less vertical axis.
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BONES FORMING THE JOINT:
1. CONDYLES OF FEMUR
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2. CONDYLES OF TIBIA3. ARTICULAR SURFACE OF PATELLA
LIGAMENTS of KNEE JOINT
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1. Capsular ligament
2. Synovial membrane
3. Ligamentum patellae
4. Tibial col ateral ligament
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5. Fibular col ateral ligament6. Oblique popliteal ligament
7. Arcuate popliteal ligament
8. Medial & lateral menisci
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9. Anterior & posterior cruciate
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ligments.10 . Coronary ligament
11. Transverse ligament.
12. Menisco - femoral ligaments.
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Proximal attachment of capsule
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Posteriorly (1 gap ) for passage of TENDON OFPOPLITEUS
Distal attachment of capsule
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Anteriorly (1 gap)
REFLECTION OF SYNOVIAL MEMBRANE
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LIGAMENTUM PATELLAE
It is derived from the tendon of quadriceps femoris &
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extends from the apex of patella to the upper part of the
tubercle of tibia.
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When the knee joint is locked at the end of extension , alligaments are taut except the ligamentum patellae.
TIBIAL COLLATERAL LIGAMENT
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The ligament consist of superficial & deep part . Both part
are attached above to the medial epicondyle of femur. The
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superficial part extends downward & forward as aflattened band & is attached to the medial condyle & upper
part of medial border of shaft of tibia along a rough strip of
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bone.
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FIBULAR COLLATERAL LIGAMENT
It extends from lateral epicondyle of
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femur to the head of fibula close to itsstyloid process.
OBLIQUE POPLITEAL LIGAMENT
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It is an expansion derived from the insertion of
semimembranosus & extend from the posterior surface
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of medial condyle of tibia to the lateral part ofintercondylar line of femur.
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ARCUATE LIGAMENTIt forms a Y-shaped band .The stem is fixed to the
styloid process of head of fibula. The posterior band is
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attached to the lateral condyle of tibia & anterior band
is attached to the lateral condyle of femur.
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CRUCIATE LIGAMENTThe anterior & posterior cruciate ligaments are
intracapsular but extrasynovial. They are named as
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anterior & posterior according to their tibial
attachment.
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CORONARY LIGAMENT: These are parts of capsule that
provide attachment to peripheral margins of medial and
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lateral menisci.TRANSVERSE LIGAMENT: It connect the anterior horn of
medial meniscus to the anterior margin of lateral meniscus.
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MEDIAL & LATERAL MENISCI
They are composed of fibro-cartilage. Each menisci
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divides the condylar part of the joint into menisco-femoral & menisco-tibial compartments.
Function of the menisci-
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1. They increase the concavity of tibial condyles for the
better adaptation with femoral condyles.
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2. They maintain a potential joint space for flushing ofsynovial fluid to provide nutrition to the articular
cartilage.
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3. Menisci act as shock absorber.
4. Menisci help in the complex mechanism of gliding &
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angular movements.5. Peripheral attached part of the menisci is vascular &
gets nutrition from the capsular arteries.
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MENISCO-FEMORAL LIGAMENT
The posterior horn of lateral meniscus is connected to
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the medial condyle of femur by anterior & posterior
menisco-femoral ligaments.
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BURSAE AROUND KNEE JOINT
Anteriorly
1. Subcutaneous pre - patellar bursa.
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(inflammation causes House maid knee).2. Subcutaneous infra- patellar bursa
( inflammation causes Clergy-mans knee)
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3. Deep infra-patellar bursa4. Supra-patellar bursa (Communicates with the
joint cavity.)
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BURSA AROUND KNEE JOINT
Lateral y :
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?Between lateral head of gastrocnemius & the
capsule
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?Between tendon of biceps femoris & fibular
collateral ligament.
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?Between fibular collateral ligament & tendon ofpopliteus muscle
?Between tendon of popliteus & lateral condyle of
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tibia (communicates with joint cavity).
Medial y
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1. Me dial head of gastrocnemius & the capsule
(communicates with joint cavity)
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2. Superficial part of tibial collateral igamentsartorius, gracilis &semitendinosus.
3. Superficial & deep part of tibial collateral ligament.
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4.Semi-membranosus & medial condyle of tibia (may
communicate with joint cavity)
RELATIONS OF KNEE JOINT
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Anteriorly- Quadriceps femoris
Antero-medial y- medial patellar retinaculum
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Antero-lateral y- lateral patellar retinaculam & iliotibialtract
Postero-medial y- Sartorius,gracilis, semimembranosus
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& semitendinosus
Postero-lateral y- Tendon of biceps femoris & common
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peroneal nervePosteriorly- popliteal vessels, tibial nerve, both head of
gastrocnemius & plantaris
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ARTERIAL SUPPLY
1. Descending genicular branch of femoral artery.
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2. Descending branch of lateral circumflex femoralartery
3. Genicular branches of popliteal artery.
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4. Recurrent branches of anterior tibial artery.
5. Circumflex fibular branch of posterior tibial artery.
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NERVE SUPPLY
?From Femoral nerve ?
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?nerves to the vasti.?3 from the Tibial nerve ?
? superior medial Genicular
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? inferior medial genicular
? middle genicular nerve.
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?3 from the Common peroneal nerve -? superior lateral Genicular
? inferior lateral genicular
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? recurrent genicular nerve
MUSCLES PRODUCING THE MOVEMENTS:
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Active movements performed at the knee joint are-
qExtension or straightening continues until leg & thigh
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are in the same vertical lines.Extension is produced byQuadriceps femoris & assisted by tensor fascia latae.
qFlexion ?prime movers: semimembranosus,
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semitendinosus, biceps femoris;
initiated by, popliteus
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Assisted by, sartorius, gracilis, both head ofgastrocnemius & plantaris.
q Medial rotation- by semimembranosus,
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semitendinosus, popliteus, sartorius & gracilis.
q Lateral rotation-biceps femoris.
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Applied Anatomy
Injuries to menisci
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qMost injured structures of the knee are Tibial col ateralligament, the medial menisci & ACL
o A blow to lateral aspect of the knee when the foot is on the
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ground may sprain the tibial col ateral ligament, the attached
medial menisci may also be torn.
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oACL tears may occur when the tibial col ateral ligament &medial menisci are injured, a blow to the anterior aspect of
the flexed knee may tear only the ACL.
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q Injuries to the menisci commonly occur in the flexed knee as
a result of forcible rotation or abduction. The medial meniscus
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suffers more frequently than the lateral.?Rupture of cruciate ligaments is less common. Anterior
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ligament is more commonly affected.?If both cruciate ligaments are injured ,excessive forward
& backward gliding of tibia ,abduction & adduction of
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joint occur.
?Fractureof patella is a frequent problem. Does not heal
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as it is a sesamoid bone. Wiring has to be done.?Acute traumatic synovitis.
Joint cavity is distended with fluid. swelling is above
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and on the sides of patella.
. Inflammation of bursa-
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Housemaids knee - Subcutaneous pre-patellar
bursa.
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Clergyman's knee - Subcutaneous infrapatellarbursa.
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. Osteoarthritis of knee joint.Genu valgum (Knock knees)
Angle between long axis of thigh and leg is reduced
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laterally
Genu varus ( bow legs)
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Angle between long axis of thigh and leg is increasedlaterally.
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