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Knee Joint: Anatomy, Ligaments, and Injuries

Explore the complexities of the knee joint, from its bony anatomy to crucial ligaments like ACL and PCL, and common injuries such as patellar dislocation. Learn about stabilizing ligaments, menisci, and muscle functions in maintaining knee stability.

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Knee Joint: Anatomy, Ligaments, and Injuries

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  1. The Knee Some slides adapted from University of Wisconsin Medical School.

  2. The Knee • One of the most complex joints • Provides stability in weight bearing and locomotion • Very vulnerable – especially medially and laterally • Muscles and ligaments provide most of the stability

  3. Instability - Example Patellar dislocation http://www.carletonsportsmed.com/Libraria_medicus/PF_patella_dislocation.JPG

  4. Bony Anatomy – 4 bones Femur Patella Tibia Fibula

  5. Bony Anatomy • Femur: Longest Bone in Body • Tibia: WB bone of lower extremity • Fibula: Site of Muscle Attachment • Patella: Sesamoid Bone • Floating bone • A bone that develops within a tendon

  6. Knee Skeletal Lateral Condyle Head of Fibula Femoral Groove Gerdy’s Tubercle Tibial Tuberosity Pes Anserine

  7. Sagittal MRI View

  8. Knee Menisci • 2 oval shaped (semilunar) fibrocartilages • Provides cushion • Avascular(poor blood supply) = decreased healing • Medial – “C” shaped • Lateral – “O” shaped

  9. Menisci Medial Meniscus Lateral Meniscus PCL ACL

  10. 4 Stabilizing Ligaments Posterior Cruciate • 2 cruciate ligaments • ACL/PCL • 2 collateral ligaments • MCL/LCL Anterior Cruciate Medial Collateral Lateral Collateral

  11. Anterior Cruciate Ligament (ACL) • Extends from tibia posteriorly and laterally to femur • Front of tibia to back of femur • Prevents anterior movement of tibia • Stabilizes against tibial rotation • Main stabilizer

  12. ACL • Torn during cutting motions • Foot planted and knee rotates • More commonly torn in girls • Less muscle, hormones, Q- angle • Surgery • Cadaver graph, patellar tendon, hamstring tendon • About 6-9 months to return to activity

  13. Healthy ACL

  14. Torn ACL

  15. Knee Posterior

  16. Posterior Cruciate Ligament (PCL) • Extends antiorly and medially from tibia to posterior femur • Prevents tibia from posterior translation • Prevents hyperextension

  17. Medial Collateral LigamentMCL • Medial side • Thick Band of Tissue • Tibia  Femur • Resists Valgus Force

  18. Valgus • Outside to Inside Force • MCL resists this force • Occurs in FRONTAL PLANE

  19. Increased Valgus

  20. Lateral Collateral Ligament LCL • Lateral side • Narrow cord-like band of tissue • Connects femur to • head of fibula • Resists Varus Force

  21. Varus • Inside to Outside Force • LCL resists this force • FRONTAL PLANE

  22. Collateral Ligament Ruptures • 3 degrees of sprains (ligament damage) • Complete tear = 3rd degree sprain

  23. Ligament Structures

  24. What do you see? Look at the left knee.

  25. Lateral View of Left Knee

  26. Ruptured Patellar Tendon 3rd degree Strain = muscle/tendon injury

  27. Lab Activity • Partner up • Get a marker • Identify structures of the knee • Patella • Head of fibula • Tibial tuberosity • Pes Anserine • Gerdy’s Tuburcle • MCL • LCL • Medial Joint Line • Lateral Joint Line • Patellar Tendon

  28. Normal Knee – Anterior, Extended

  29. Surface Anatomy - Anterior, Extended* Patella Indented Hollow

  30. Normal Knee – Anterior, Flexed

  31. Surface Anatomy - Anterior, Flexed Patella Tibial Tuberosity Head Of Fibula

  32. Palpation – Anterior* Patella: Lateral and Medial Patellar Facets Superior And Inferior Patellar Facets Medial Fat Pat Lateral Fat Pad Patellar Tendon**

  33. Surface Anatomy - Medial Patella Tibial Tuberosity Medial Femoral Condyle Joint Line Medial Tibial Condyle

  34. Palpation - Medial Medial Collateral Ligament (MCL)* Pes anserine bursa** Medial joint line

  35. Surface Anatomy – Lateral Patella Quadriceps Tibial Tuberosity Head Of Fibula

  36. Palpation – Lateral* Lateral Collateral Ligament (LCL)** Lateral joint line

  37. You should have the following drawn on your partner’s knee • Patella • Head of fibula • Tibial tuberosity • Medial joint line • Lateral joint line • Patellar tendon • MCL • LCL • Pes Anserine • Gerdy’s tubercule

  38. Quadriceps and Patellar Tendons • Quadriceps Tendon • All 4 muscles come together at patella • Patellar Tendon • From inferior patella to tibialtuberosity

  39. Quadriceps • Anterior Thigh Musculature • Four Muscles: • Rectus Femoris • Vastus Lateralis • Vastus Medialis • Vastus Intermedius • Extend the Knee

  40. Quadriceps

  41. Rectus Femoris • 2 Joint Muscle • Crosses hip and knee • Flexes Hip • Extend the knee • Converges with rest of quadriceps muscles at tibial tubercle

  42. Hamstrings • Three Muscles • Semimembranosus • Semitendinosus • Biceps Femoris • Common Origin the ischial tuberosity • Flex the Knee

  43. Hamstrings

  44. Popliteus

  45. Popliteus

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