However, while this is a satisfactory concept in terms of flexion and extension, in reality the situation is more complex because the knee allows not only gliding and rotation around a horizontal axis but also rotation through a vertical axis, i.e. The majority of the movement allowed by the knee is the same type of motion allowed by a door hinge. (b) By flattening the anterior and posterior end of the ‘rail’, rotational movements become possible; the intercondylar spines act as the central pivot. a flexed position modifications enable axial rotation around a central pivot. The femur or thighbone is the bone connecting the hip to the knee. the knee joint (Fig. To measure the extent of internal and external rotation, the knee must therefore be flexed to a right angle. 1. In humans and other primates, the knee joins the thigh with the leg and consists of two joints: one between the femur and tibia (tibiofemoral joint), and one between the femur and patella (patellofemoral joint). The superior border of the patella is thick, and sloped from behind, downwards and forwards; it gives attachment to that portion of the quadriceps which is derived from the rectus femoris and the vastus intermedius muscles. The patella is a flat, triangular bone, situated on the front of the knee joint (Fig. The inner non-vascularized part receives nutrition through diffusion of synovial fluid.9,10. They are crescent-shaped lamellae, each with an anterior and a posterior horn, and are triangular in cross section. There are two menisci in the space between the femoral and tibial condyles. Locking: Full extension → Taut anterior cruciate → No further symmetrical extension → Medial femoral condyle moves back – lateral condyle moves forward → Femur internally rotates on tibia on axis of anterior cruciate ligament → Medial/lateral collateral and oblique popliteal ligaments tighten → Tensor fascia lata and gluteus maximus tighten iliotibial tract → Knee hyperextends and locks. Terms and conditions  If the intercondylar eminence of the tibia is projected anteriorly, its plane is continuous with the vertical ridge on the patella just as the intercondylar notch of the femur continues in the central groove of the patellar surface of the femur. The posterior surface presents above a smooth, oval, cartilaginous area, which is divided by a rounded vertical ridge into a larger, lateral portion, for articulation with the lateral condyle of the femur, and a smaller, medial portion, for articulation with the medial condyle of the femur. These include the iliotibial tract syndrome, the anserine syndrome, bursitis of the medial collateral ligament, Baker's cyst, popliteus tendon tenosynovitis and bursitis of the deep infrapatellar bursa. internal and external rotation of the tibia in relation to the femur. These three bones are covered in articular cartilage which is an extremely hard, smooth substance designed to decrease the friction forces. Knee joint is the largest joint in the body. The former is measured by a line drawn from the ASIS (Anterior superior iliac spine) to center of patella. Knee joint (Articulatio genu) The knee joint is a synovial joint that connects three bones; the femur, tibia and patella.It is a complex hinge joint composed of two articulations; the tibiofemoral joint and patellofemoral joint.The tibiofemoral joint is an articulation between the tibia and the femur, while the patellofemoral joint is an articulation between the patella and the femur. The knee is a complex joint that flexes, extends, and twists slightly from side to side. Various nerves and blood vessels supply the muscles and bones of the k… 2). The popliteus sends a fibrous expansion to the posterior border of the lateral meniscus and a few fibres of the semimembranosus tendon run to the posterior edge of the medial meniscus. A fourth bone, the fibula, is located just next to the shin bone (tibia) and knee joint, and can play an important role in some knee conditions. 3).8. It must therefore reconcile two opposed requirements, namely mobility and stability. Use the mouse scroll wheel to move the images up and down alternatively use the tiny arrows (>>) on both side of the image to move the images.>>) on both side of the image to move the images. Note: Biceps femoris, semitendinosus and semimembranosus forms the Hamstring muscles which are the major flexors of the knee joint. Slight valgus position: angle between longitudinal axis of femur and tibia is 170º opened laterally. Nerve structures and blood vessels: the popliteal fossa. Nevertheless, the exposure of the knee to external forces makes it very vulnerable in many occupations and sports. It additionally allows for a small amount of rotational movement. In fact this is not so. Degenerative diseases: Knee is the commonest site for osteoarthritis. Normal Anatomy and Biomechanics of the Knee Fred Flandry, MD, FACS*w and Gabriel Hommel, MD* Abstract: Functionally, the knee comprises 2 articulations—the patellofemoral and tibiofemoral. Save my name, email, and website in this browser for the next time I comment. 5a. separates anterior and posterior cruciate ligaments, Styloid process of head: attachment for fibular collateral ligament and biceps tendon. Like the shoulder, the knee is a joint. Summary: It is the reversal of locking brought by popliteus muscle. There are 13 bursae around knee – 4 Anterior, 2 Medial, 2 Lateral and 4 Posterior. 4). Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), Presurgical Functional MappingAndrew C. Papanicolaou, Roozbeh Rezaie, Shalini Narayana, Marina Kilintari, Asim F. Choudhri, Frederick A. Boop, and James W. Wheless, the Child With SeizureDon K. Mathew and Lawrence D. Morton, and Pharmacologic Consequences of SeizuresShilpa D. Kadam and Michael V. Johnston, Self-Limited EpilepsiesDouglas R. Nordli, Jr., Colin D. Ferrie, and Chrysostomos P. Panayiotopoulos, in Epilepsy: A Network and Neurodevelopmental PerspectiveRaman Sankar and Edward C. Cooper, Hematology, Oncology and Palliative Medicine, The distal femur can be compared with a double wheel, in which the medial and lateral condyles are the components and the intercondylar notch the junction between them (. They are crescent-shaped lamellae, each with an anterior and a posterior horn, and are triangular in cross section. Fig 1 (a) The knee as a hinge joint: the femoral condyles (twin wheel) in relation to the tibial and patellar surfaces (‘rails’). This arrangement resembles a twin-wheel rolling on a central rail (, The rounded surfaces of the femoral condyles in relation to the flatter tibial ones might suggest that the former roll during flexion–extension. 1b). Knee joint anatomy, type of joint, articular surfaces, capsule and synovial membrane, movements, locking and unlocking of knee joint, applied anatomy Fig 2 Surfaces of the patella: (a) anterior; (b) posterior. The clinical anatomy of several pain syndromes of the knee is herein discussed. The anatomy of the knee provides a standardised description of articular surfaces, ligament and tendinous insertions in order to understand the combined action of the femoro-tibial and femoro-patellar compartments, as well as their stabilisation mechanisms. 82.20). The knee joint is fl exed and attached to the bone of the thigh. 3. Comment policy  The remaining middle part of the eminence, forming the ‘intercondylar spines’, is then the central pivot about which the movements of axial rotation occur. Fig 3 Superior view of the menisci and their attachments (right knee). The knee is one of the largest and most complex joints in the body. Were the knee to be only as so far described – a hinge joint with a long tibial intercondylar eminence gliding between the two femoral condyles – rotation would be precluded. In lateral (axial) rotation, the menisci will follow exactly the displacement of the femoral condyles, which means that the lateral meniscus will be pushed forwards on the tibia and the medial meniscus will be pulled backwards (, Applied anatomy of the wrist, thumb and hand, Applied anatomy of the temporomandibular joint, Applied anatomy of the lower leg, ankle and foot, Disorders of the inert structures: Ligamentous instability. Nevertheless, the isolated vision of the a … 1, lateral collateral ligament; 2, medial collateral ligament; 3, medial coronary ligament; 4, lateral coronary ligament; 5, popliteus tendon; 6, posterior cruciate ligament; 7, semimembranosus tendon. Menisci do not contain pain-sensitive structures and are consequently insensitive to trauma. The knee joins the thigh bone (femur) to the shin bone (tibia). As long ago as 1836 the Weber brothers demonstrated that the femoral condyles roll and slide almost simultaneously, and that these movements are in opposite directions. The normal Q angle is between 15 -20º. Glaucoma Basics – Aqueous humor dynamics and Intraocular pressure, https://epomedicine.com/medical-students/applied-anatomy-of-knee-joint/, IV Cannula Color Code : Tricks to Remember, Use of Thyroid Function Test in Adult, Non-pregnant patients, Constructing Differential Diagnoses : Mnemonic, Common mistakes in Per Abdominal examination, A Case of Neonatal Umbilical Infection leading to Septic Shock, Partial Exchange transfusion for Neonate with Polycythemia, A Child with Fever, Diarrhea, AKI, Hematuria, Altered senosrium and Anemia, Case of Cyanotic Congenital Heart Disease : PGE1 saves life, A Classical case of Congenital Diaphragmatic Hernia, Lateral femoral condyle/posterior capsule, Quadriceps femoris (Rectus femoris, Vastus- medialis, intermedius, lateralis), Head of fibula and lateral condyle of tibia, Pes anserinus (Sartorius, gracilis, semitendinosus), Anteriomedial surface of proximal tibial, just below condyle, Knee flexion and internal rotation (semitendinosus); external roatation (Sartorius), Posteromedial surface of medial tibial condyle, Posterior surface of femur, near or on respective condyles, Lateral supracondylar ridge of femur above gastrocenmius, Distal femur possess 2 condyles of which the medial one is larger, Medial epicondyle is more porminent and supports the adductor tubercle, enhances lubrication and nutrition of knee. The inner non-vascularized part receives nutrition through diffusion of synovial fluid. During flexion of the knee, the body of the meniscus moves posteriorly and during extension it moves anteriorly. The patella is a flat, triangular bone, situated on the front of . Anterior Cruciate Ligament (ACL) Stability Tests, Your email address will not be published. However, if the anterior and posterior ends are flattened, rotation becomes possible (, The patella is a flat, triangular bone, situated on the front of the knee joint (. During flexion of the knee, the body of the meniscus moves posteriorly and during extension it moves anteriorly. The body of each meniscus is fixed around the femoral condyle and moves with the femur. The horns of the medial meniscus are further apart than those of the lateral, which makes the former nearly semilunar and the latter almost circular. The knee is made up of four bones. 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