ITHelpdesk-actually2jointswithinthearticularcapsuletibio-actually2jointswithinthearticularcapsuletibio-femoralpatello-femoralthesuperiorfibulo-tibialjointisalsonearmodifiedhingejointflexionandextensionisprimarymotionsomerotationispossiblewhenthekneeisflexedKneeJointAnteriorPosteriorAnteriorTransversecondylesepicondy...
actually2jointswithinthearticularcapsuletibio-femoralpatello-femoralthesuperiorfibulo-tibialjointisalsonearmodifiedhingejointflexionandextensionisprimarymotionsomerotationispossiblewhenthekneeisflexedKneeJointAnteriorPosteriorAnteriorTransversecondylesepicondylesintercondylarnotchpatellatibialtuberositytibialplateausLigamentousSupportMenisciCollateralLigamentsCruciateLigamentsOtherLigamentsMenisciThemenisciarediscsoffibrocartilageattachedtotibialplateaus.Theyarethickeralongtheperiphery.Thelateralmeniscusissmallerandmoremobilethanthemedialmeniscus.Theinnerportionofthemenisciareavascular.Theouterportionhassomebloodsupply,makinghealingoftearspossible.lateralmedialMenisciFunctionincreasesstabilitybydeepeningtibialplateausdecreasesfrictionby20%increasescontactareaby70%absorbsshockremovalofmeniscidoesNOTprecludenormalmotion,butincreasewearonarticulatingsurfacesincreasechanceofdevelopingdegenerativejointdiseaselateral(fibular)medial(tibial)CollateralLigamentspreventsabductionandadductionmovementofthekneeCollateralLigamentsAdditionalLigamentousSupportiliotibialbandthick,strongbandoftissueconnectingtensorfascialataetofemurandtibiaAnteriorCruciate(ACL)CruciateLigamentscruciate--‘cross’ligamentsforman‘X’orcrosswithinthejointnamedfortheirTIBIALattachmentsPosteriorCrucuate(PCL)shorterandstrongerthanACLFEMURTIBIAPATELLATheACLpreventsthefemurfromslidingposteriorlyonthetibiaorthetibiafromslidinganteriorlyonthefemur.ThePCLpreventsthefemurfromslidinganteriorlyonthetibiaorthetibiafromslidingposteriorlyonthefemur.ThePCLpreventsthetibiafromslidingposteriorlyonthefemur.AnteriorPosteriorCruciatesDuringFlexion/ExtensionNote:thecruciateligamentsalsolimitrotationPatello-femoralJointarticulationofthepatellaandfemurthepatellaisatruesesamoidboneposteriorsurfaceofthepatellaiscoveredwiththickhyalinecartilagethepatellaslideswithinthetrochleargrooveFunctionsofPatello-femoralJoint(1)increasesangleofpullofquadsontibia,improvestheratioofmotive:resistivetorqueby50%(2)centralizesdivergenttensionofquadsintoasinglelineofaction(3)someprotectionofanterioraspectofkneewithoutpatellawithpatellaQ-AngleTheQ-angleistheangleformedbyalinefromtheanteriorsuperiorspineoftheiliumtothemiddleofthepatellaandalinefromthemiddleofthepatellatothetibialtuberosity.MalestypicallyhaveQ-anglesbetween10to14o,femalesbetween15-17o.AtypicalQ-anglesbowleggednessknock-kneesKneeRotation(LockingYourKnee)Sixto30degreesofinternalrotationofthetibiaonthefemuroccursthrough90degreesofkneeflexion.Thefemoralcondylesdonothavethesamediameters,thishelpscauseinternalrotationwhenthekneeisflexedandexternalrotationwhenthekneeisextended.Thelateralcondyleslidesmorethanmedialcondyle.Theanteriorcruciateligamentbecomestautjustpriortotherotation,thismayhelpforcearotationofthefemuronthetibia.FlexionExternalRotationInternalRotationExtensionKneeMusculaturemany2jointmusclesprimarymovements-flexionandextension-hams&quads,respectivelymedialandlateralrotationpossiblenecessaryforscrew-homemechanismKneeFlexionHamstringscrosshipandkneebicepsfemorissemitendinosussemimembranosusgastrocnemiuscrosskneeandanklepopliteusrectusfemorisvastuslateralisvastusmedialisvastusintermediusquadricepstendonpatellarligamentKneeExtension-QuadricepsLateralRotationbicepsfemorisattachestolateralaspectofkneeMedialRotationsemitendinosussemimembranosuspopliteusattachtomedialaspectofkneeCommonKneeInjuriesoneofthemostcommonlyinjuredjointslackofbonyandmuscularsupportpositionedbetweenthe2longestbonesweightbearingandlocomotionfunctionsoftentearorstretchingofsofttissueLigamentInjuriesACLmoreprevalentthanPCLinjuriesforcesdirectedfromposteriorsideoflegPCLforcesdirectedfromanteriorsideoflegforcedflexionofkneew/externalrotationwrestlingandfootballIntactKneewithACL&PCLRupturedACLKneeMechanismsofACLinjury1)attemptingarapidcuttingmaneuverwithfootincontactwiththegroundandkneeflexed(problemexacerbatedifanexternalforceappliedtokneeduringthismovement)2)kneehyperextensionwithinternaltibialrotationExamplebackwardfallingskier-bootandskisaccelerateforwardcreatingananteriordrawermechanismGenderissuesrelatedtoACLinjuriesfemalesmorelikelytosustainanACLinjurythanmalessoccer-2.6Xbasketball-5.75Xwiderpelvisgreaterflexibilityless-developedmusculaturehypoplasticvastusmedialisobliquusnarrowfemoralnotchgenuvalgumexternaltibialtorsionPCLInjuriesWhenthekneeisforcefullytwistedorhyperextendedBUTotherligamentsareusuallyinjuredortorn,beforetheposteriorcruciateligament(PCL)istornMostcommonmechanismforPCLalonetobeinjuredisfromadirectblowtothefrontofthekneewhilethekneeisbent. AutomobileaccidentAutomobilestrikesanotherandstopssuddenlyFrontpassengerordriverslidesforward. BentkneehitsthedashboardjustbelowthekneecapforcingtibiabackwardsonthefemurtearingPCL.Thesameforcecanoccurduringafallonthebentknee,wheretheforceofthefallonthetibiapushesitbackagainstthefemurandtearstheposteriorcruciateligament(PCL).WhenthetibiaisdisplacedtoomuchintheposteriordirectionthePCLmayrupture.CommonmechanismofPCLinjuryinfootballisbeingtackledwhilethekneeisfullyextended.LigamentInjuriesinjuriestoMCLmoreprevalentthanLCLMCLfootplantedandforceappliedtothelateralsideofkneefootballMLMeniscusInjuriesmostcommoninjuryinthekneetearingismostcommonmedialsideinjuredmoreoftenmedialmeniscusmoresecuredfootplantedwithexcessiverotationIliotibialBandSyndromeIT-bandthickstrongbandofligamentoustissueconnectstensorfascialataetothelateralcondyleofthefemurandthelateraltuberosityofthetibiaIT-bandrubsagainstthelateralfemoralcondylewhenthereisexcessivetensionexcessivepronationincreasesinternalrotationofthetibia,whichaccentuatesthefrictionoftheITbandandfemoralcondyletibialalignmentandsizeoffemoralcondylemayalsocontributetothedevelopmentofthiscondition
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