Knee Joint Ug

KNEE JOINT
INTRODUCTION
• Knee joint is the largest and most complex
joint of the body.
• It is formed by the fusion of the lateral
femorotibial, medial femorotibial and
femoropatellar joints.
TYPE OF JOINT
• COMPOUND SYNOVIAL JOINT
Two condylar joints between the condyles of
the femur and tibia.
• SADDLE JOINT
Between the femur and the patella.
ARTICULAR SURFACES
• Knee joint is formed by :
1. The condyles of the femur.
2. The patella ( upper three-quarters of the patella
articulates with the femur and is subdivided into a
medial and lateral facet by a vertical ledge which
varies in shape. Lower part of the posterior surface
has vascular canaliculi filled and is filled by fatty
tissue , the infra patellar fat pad)
3. The condyles of the tibia. The femoral condyles
articulate with the tibial condyles .
LIGAMENTS SUPPORTING THE KNEE JOINT
1. FIBROUS CAPSULE
2. LIGAMENTUM PATELLAE
3. TIBIAL COLLATERAL OR MEDIAL LIGAMENT
4. FIBULAR COLLATERAL OR LATERAL LIGAMENT
5. OBLIQUE POPLITEAL LIGAMENT
6. ARCUATE POPLITEAL LIGAMENT
7. ANTERIOR CRUCIATE LIGAMENT
8. POSTERIOR CRUCIATE LIGAMENT
9. MEDIAL MENISCUS
10. LATERAL MENISCUS
11. TRANSVERSE LIGAMENT
• Fibrous capsule
Very thin
Deficient anteriorly and it is replaced by the
quadriceps femoris, the patella and the
ligamentum patellae
• Ligamentum patellae
It is attached above to the margins and rough posterior
surface of the apex of the patella. Below to the
smooth , upper part of the tibial tuburosity.
Superficial fibres pass in front of the patella.
• Tibial collateral or medial ligament
• Tibial collateral or medial ligament
Long and has great strength.
Superiorly-attached to the medial epicondyle of the
femur .
Inferiorly it divides into anterior and posterior parts
It is attached below to the medial border and posterior

part of the medial surface of the shaft of the tibia.
Covers inferior medial genicular vessels and nerves
Posteriorly- short and blends with the capsule and with
the medial meniscus. It is attached to the medial
condyle of the tibia .
• Fibular collateral or lateral ligament
Strong and cord like. And 5 cm long.
Superiorly it is attached to the lateral epicondyle of femur .
Inferiorly , it is embraced by the tendon of biceps femoris and is
attached to the head of fibula in front of its apex
• Oblique popliteal ligament:
This is an expansion from the tendon of the
semimembranosus. It runs upwards and laterally ,
blends with the posterior surface of the capsule, and
attached to the intercondylar line and lateral condyle
of the femur
• Arcuate popliteal ligament:
It is Y shaped and is attached to the posterior portion of the
head of the fibula. From there it goes to its two insertions; the
medial one goes over popliteus muscle and joins the oblique
popliteal ligament, the lateral one to the lateral epicondyle of
the femur and joins with the lateral head of the
gastrocnemius muscle.
• Cruciate lgaments:
These are very thick and strong fibrous bands,
which acts as direct bands of union between
tibia and femur, to maintain anteroposterior
stability of knee joint.
• Anterior cruciate ligament:
It begins from anterior part of intercondylar area
of tibia , runs upwards, backwards and
laterally and is attached to the posterior part
of medial surface of lateral condyle of femur .
It is used during extension of knee.
• Posterior cruciate ligament:
It begins from the posterior part of intercondylar
area of tibia , runs upwards , forwards and
medially and is attached to the anterior part of
the lateral surface of medial condyle of femur.
It is taut during flexion of knee.
• Medial and lateral meniscus
Menisci are two fibrocartlagenous disc . They are shaped like
crescents. They deepen the articular surfaces of the condyles
of tibia. It divides the joint cavity into upper and lower
compartments.
Flexion and extension- upper compartment
Rotation-lower compartment
Medial meniscus is nearly semicircular and lateral is nearly
circular
They serve as shock absorbers
Lubricate joint cavity
• Transverse ligament
It connects the anterior ends of medial and
lateral menisci
SYNOVIAL MEMBRANE
The synovial membrane of the knee joint lines
the capsule , except posteriorly where it is
reflected forwards by the cruciate ligaments,
forming a common covering for both the
ligaments.
In front of patella: it is absent
Above the patella: prolonged upwards for 5 cm
or more as suprapatellar bursa.
Below the patella: it covers the deep surface of
the infra patellar pad of fat, which separates it
from ligamentum patellae.
Median fold: the infrapatellar synovial fold ,
extends backwards from the pad of fat to the
intercondylar fossa of the femur.
Bursae around the knee
• Bursae: fluid filled , sac like cavities are known

as bursae. These are located where muscles
and tendons move over bony joint areas. Their
function is to reduce friction caused by
muscles and tendons moving against skin and
bones , as well as to facilitate movement.
• 12 bursae have been described: 4 anterior, 4
lateral and 4 medial.
• ANTERIOR:
1. Subcutaneous prepatellar bursa
2. Subcutaneous infrapatellar bursa
3. Deep infrapatellar bursa
4. Supra patellar bursa
• LATERAL:
1. A Bursa deep to the lateral head of gastrocnemius
2. Bursa between the fibular collateral ligament and
the biceps femoris
3. Between fibular collateral ligament and the tendon
of popliteus
4. Between the tendon of the popliteus and the lateral
condyle of tibia.
• MEDIAL:
1. Bursa deep to the medial head of the
gastrocnemius
2. Anserine bursa
3. Bursa deep to the tibial collateral ligament
4. Bursa deep to the semimembranosus
RELATIONS OF KNEE JOINT
• ANTERIORLY:
Anterior bursa
Ligamentum patellae
Patellar plexus of nerves.
• POSTERIORLY
a) At the middle: popliteal vessels, tibial nerve.
b) Posterolaterally: lateral head of gastrocnemius,
plantaris and common peroneal nerve .
c) Posteromedially:medial head of gastrocnemius,
semitendinosus , semimembranosus, gracilis
and poploteus at its insertion.
• MEDIALLY:
Sartorius, gracilis and semitendinosus
Great saphenous vein with saphenous nerve.
Semimembranosus.
• LATERALLY:
Biceps femoris and tendon of origin of popliteus.
BLOOD SUPPLY
• Five genicular branches of the popliteal artery.
• The descending genicular branch of the
femoral artery.
• The descending branch of the lateral
circumflex femoral artery
• 2 recurrent branches of the anterior tibial
artery.
• The circumflex fibular branch of the posterior
tibial artery.
NERVE SUPPLY
• FEMORAL NERVE, through its branches to the
vasti, especially the vastus medialis.
• SCIATIC NERVE, through the genicular
branches of the tibial and common peroneal
nerves.
• OBTURATOR NERVE, through its posterior
division.
Movements of the knee joint
• FLEXION
• EXTENSION
• MEDIAL ROTATION
• LATERAL ROTATION
• Flexion and extension are the chief

movements.

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KNEE JOINT

It is attached below to the medial border and posterior

• Bursae: fluid filled , sac like cavities are known

• Flexion and extension are the chief

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