Chapter 9. Knee Joint

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1 Chapter 9 Knee Joint

2 The Knee Joint tibiofemoral (knee) joint largest and most complex diarthrosis of the body primarily a hinge joint capable of slight rotation and lateral gliding when knee flexed patellofemoral joint gliding joint joint capsule encloses only the lateral and posterior aspects of the knee, not the anterior anterior covered by patellar and lateral and medial retinacula all are extensions of the tendon of quadriceps femoris muscle

3 The Knee Joint knee stabilized by quadriceps tendon in front tendon of semimembranosus muscle on rear side of thigh joint cavity contains two C- shaped cartilages lateral meniscus and medial meniscus absorbs shock on the knee prevents femur from rocking side-to-side on the tibia joined by transverse

4 The Knee Joint popliteal region of knee supported by a complex array of: extracapsular s external to joint capsule prevent knee from rotating when joint is extended fibular (lateral) collateral tibial (medial) collateral two intracapsular s deep within joint capsule synovial membrane folds around them, so they are excluded from the fluid filled synovial cavity s cross each other to form an X anterior cruciate (ACL) prevents hyperextension of knee when ACL is pulled tight one of the most common sites of knee injury posterior cruciate (PCL) prevents femur from sliding off tibia prevents the tibia from being displaced backward

5 The Knee Joint ability to lock the knees important aspect of human bipedalism when knee is extended to the fullest degree allowed by ACL femur rotates medially on the tibia locks the knee, and all major knee s are twisted and taut unlock knee popliteus muscle rotates the femur laterally and untwists the s

6 Knee Joint Sagittal Section Quadriceps femoris Femur Bursa under lateral head of gastrocnemius Joint capsule Articular cartilage Meniscus Quadriceps femoris tendon Suprapatellar bursa Prepatellar bursa Patella Synovial membrane Joint cavity Infrapatellar fat pad Superficial infrapatellar bursa Tibia Patellar Deep infrapatellar bursa knee joint has at least 13 bursae four anterior: superficial infrapatellar, suprapatellar, prepatellar, and deep infrapatellar popliteal region: popliteal bursa and semimembranosus bursa seven more bursae on lateral and medial sides of knee joint

7 Knee Joint Anterior and Posterior Views Femur Femur Patellar surface Medial condyle Lateral condyle Fibular collateral Lateral meniscus Transverse Fibula Tibia Medial condyle Posterior cruciate Anterior cruciate Medial meniscus Tibial collateral Patellar (cut) Tibial collateral Medial meniscus Posterior cruciate Fibula Tibia Anterior cruciate Fibular collateral Lateral meniscus Articular cartilage of tibia (a) Anterior view (b) Posterior view

8 Knee Joint Superior View Lateral meniscus Posterior cruciate Medial meniscus Synovial membrane Medial condyle of tibia Lateral condyle of tibia Anterior cruciate (d) Superior view of tibia and menisci medial and lateral meniscus absorb shock and shape joint

9 Dissection of Knee Joint Lateral Medial Femur: Shaft Patellar surface Medial condyle Lateral condyle Joint capsule Joint cavity: Anterior cruciate Medial meniscus Lateral meniscus Tibia: Lateral condyle Medial condyle Tuberosity Patellar Patella (posterior surface) Articular facets Quadriceps tendon (reflected)

10 Knee Injuries highly vulnerable to rotational and horizontal stress most common injuries are to the meniscus and anterior cruciate (ACL) Twisting motion heal slowly due to scanty blood flow Foot fixed arthroscopy procedure in which the interior of the joint is viewed with a pencil-thin arthroscope inserted through a small incision less tissue damage than conventional surgery recovery more quickly arthroscopic ACL repair about nine months for healing to be complete Anterior cruciate (torn) Tibial collateral (torn) Medial meniscus (torn) Patellar

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