Download MBBS Knee Joint Lecture PPT

INTRODUCTION

? The knee joint is the

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largest and most

complicated joint in the

body.

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? It is a modified hinge

variety of synovial joint (

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because it allows some

rotatory movements

beside flexion and

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extension )
? It consists of 3 joints

1. Medial condylar joint -

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between the medial condyle of

the femur & medial condyle of

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Tibia.

2. Lateral condylar joint ?

between the lateral

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condyle of tibia & lateral

condyle of femur.

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3. Patellofemoral joint ?

between the patella &

Patellar(trochlear) surface of

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the femur

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TIBIOFEMORAL JOINT

PATELLOFEMORAL JOINT

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? The patellofemoral joint is composed of the

suprapatellar pouch, the patella bone, trochlear

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surface, the medial and lateral femoral condyles, and

the medial and lateral patellofemoral ligaments

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CAPSULE


SYNOVIAL MEMBRANE

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LIGAMENTS

? CORONARY LIGAMENT.

? LIGAMENTUM PATELLAE.

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? ANTERIOR CRUCIATE LIGAMENT.

? POSTERIOR CRUCIATE LIGAMENT.

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? TIBIAL/MEDIAL COLLATERAL LIGAMENT.

? FIBULAR/LATERAL COLLATERAL LIGAMENT.

? OBLIQUE POPLITEAL LIGAMENT.

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? ARCUATE POPLITEAL LIGAMENT.

? MEDIAL MENISCUS.

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? LATERAL MENISCUS.

? TRANSVERSE LIGAMENT.

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CORONARY LIGAMENT


LIGAMENTUM PATELLAE

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Attaches the

Patella to the Tibia.

It is the continuation

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of the tendon of

Quadriceps Femoris
CRUCIATE LIGAMENT

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ANTERIOR CRUCIATE LIGAMENT

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? the anterior cruciate ligament attaches to

a facet on the anterior part of the

intercondylar area of the tibia and ascends

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posteriorly to attach to a

facet at the back of the lateral wall of the

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intercondylar fossa of the femur.

? The anterior cruciate ligament crosses

lateral to the posterior cruciate ligament as

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they pass through the intercondylar region.

? The anterior cruciate ligament prevents

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anterior displacement of the tibia relative to

the femur.

? it is taut during knee extension

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POSTERIOR CRUCIATE LIGAMENT

? the posterior cruciate ligament

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attaches to the posterior aspect of

the intercondylar area of the tibia

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and ascends anteriorly to attach to

the medial wall of the intercondylar

fossa of the femur.

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? posterior cruciate ligament

restricts posterior displacement.

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? it tauts during knee flexion


MEDIAL COLLATERAL LIGAMENT (MCL)

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OR TIBIAL COLLATERAL LIGAMENT

? Is attached superiorly to the medial

condyle of the femur just below

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adductor tubercle.

? Inferiorly it divides into superficial

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and deep

? Superficial part attached to the

upper third of the tibia, as far down

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as the tibial tuberosity

? The deep portion, which is short,

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fuses with the capsule and with the

medial meniscus

? A bursa usually separates the two

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parts

? MCL, tightens in extension

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LATERAL/FIBULAR COLLATERAL

LIGAMENT (LCL)

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? Superiorly attached to lateral

condyle of femur just above popliteal

groove.

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? Inferiorly embraced with tendon of

biceps femoris and attached to head

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of fibula in front of its apex.

? Seperated from lateral meniscus by

popliteal tendon and fibrous capsule

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Oblique Popliteal Ligament

? It is an expansion from the

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semimembranosus tendon

close to its insertion to the

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tibia.

? Oblique popliteal ligament

passes upwards and laterally.

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? Fuses with the Fabella if

present

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MENISCI

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BURSAE AROUND KNEE JOINT

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There are about 12 bursae around the knee, four

anterior, three lateral, three medial, and two

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posterior.


ANTERIOR BURSAE

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? Suprapatellar bursa

?Subcutaneous

Prepatellar bursa

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? Subcutaneous

infrapatellar bursa

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? Deep infrapatellar

bursa

LATERAL & MEDIAL BURSAE

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POSTERIOR BURSAE

1. The bursa between the lateral head of

gastrocnemius and capsule of the joint.

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2. The bursa between the medial head of

gastrocnemius and capsule of the joint (Brodie's

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bursa).

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MOVEMENTS

The following movements occur at the knee joints:

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1. Flexion

2. Extension } Main/active movements.

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3. Medial rotation

4. Lateral rotation } Conjunct movements.

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FLEXION & EXTENSION

These movements occur in the upper meniscofemoral compartment of

the joint, i.e., above the menisci.

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In flexion the angle between the posterior thigh and leg is decreased

whereas in extension the angle between the posterior thigh and leg is

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increased (i.e., return from the flexion back to the anatomical position).


MEDIAL& LATERAL ROTATION

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These movements take place in the lower meniscotibial

compartment of the joint, i.e., below the menisci. These

movements occur around the vertical axis.

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The medial and lateral rotations usually occur with flexion

and extension (conjunct rotations) but may occur

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independently if the knee is flexed (adjunct rotations).



CLINICAL CORRELATION

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Injury of cruciate ligaments of the knee joint:

A, rupture of anterior cruciate ligament (positive anterior

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Drawer's sign); B, rupture of the posterior cruciate ligament

(positive posterior Drawer's sign).