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1. KNEE JOINT
By: Kikatoli Zhimomi
Department of anatomy

2. KNEE JOINT:
• It is largest and most complex joint of the body
• Fusion of three joints namely -
1) Lateral femorotibial joint
2) Medial femorotibial joint
3) Femoropatellar joint

3. TYPE:
• Condylar synovial joint
• Two condylar joints b/w tibia and femur
• One saddle joint b/w femur and patella

4. ARTICULAR SURFACES :
Formed by –
1. Condyles of femur
2. Patella
3. Condyles of tibia
• Femoral condyles articulates with tibial condyle below & behind
and patella in front

5. LIGAMENTS :
Supported by following ligaments –
1. Capsular ligament
2. Ligamentum patellae
3. Tibial collateral ligament
4. Fibular collateral ligament
5. Oblique popliteal ligament
7. Arcuate popliteal ligament
8. Medial & lateral menisci
9. Anterior & posterior cruciate ligaments
10. Coronary ligament
11. Transverse ligament

6. 1. Fibrous capsule:
 Femoral attachment –
• Anteriorly - deficient
• Posteriorly - attached to intercondylar line
• Laterally - encloses origin of popliteus

7.  Tibial attachment -
• Anteriorly - descends along the margins of
condyles to tibial tuberosity
• Posteriorly - attached to intercondylar
eminence
• Posterolaterally - a gap for passage for tendon
of popliteus muscle

8.  Coronary ligament:
• These are parts of capsule that provide
attachment to peripheral margins of
medial and lateral menisci.

9. 2. Ligamentum patellae:
• Derived from the tendon of
quadriceps femoris
• Extends from the apex of patella to
the upper part of the tubercle of tibia
• When the knee joint is locked at the
end of extension, all ligaments are
taut except the ligamentum patellae

10. 3.Tibial collateral ligament:
• Consist of superficial and deep part
• Both part are attached above to the
medial epicondyle of femur
• The superficial part extends downward
and forward as a flattened band.
Attached to the medial condyle and
upper part of medial border of shaft of
tibia .
• The deep part blends with capsule and
is attached to medial condyle of tibia

11. 4. Fibular collateral ligament:
• Extends from lateral epicondyle
of femur to the head of fibula
close to its styloid process.

12. 5. Oblique popliteal ligament:
• Derived from the insertion of
semimembranosus
• Extends from the posterior surface
of medial condyle of tibia to the
lateral part of intercondylar line of
femur

13. 6. Arcuate popliteal ligament:
• It forms aY-shaped band
• Stem is fixed to the styloid process of head
of fibula
• Posterior band is attached to the lateral
condyle of tibia
• Anterior band is attached to the lateral
condyle of femur

14. 7. Cruciate ligaments:
• These are very thick and strong fibrous bands,
to maintain antero-posterior stability of knee
joint.
1. ACL : Begins from anterior part of
intercondylar area of tibia and gets attached
to the posterior part of the medial surface of
lateral condyle of femur.
2. PCL : Begins from posterior part of
intercondylar area of tibia and gets attached
to the anterior part of the lateral surface of
medial condyle of femur.

15. 8. Medial and lateral menisci:
• They are composed of fibro-cartilage
• Shaped like crescents.
a) Medial menisci : Semicircular, Wider behind than infront.
b) Lateral menisci : Circular.

16. FUNCTIONS OF MENISCI :
• They increase the concavity of tibial condyles for the better adaptation
with femoral condyles
• Menisci act as shock absorber
• They help in lubricating the joint cavity.

17. 10.Transverse ligament:
• It connect the anterior horn of medial meniscus to the anterior margin of
lateral meniscus

18. SYNOVIAL MEMBRANE :
• The synovial membrane lines the joint and produces synovial fluid to cushion
the movement of the joint.

19. BURSAE:
• A bursa is a fluid-filled structure that is present between the skin and
tendon or tendon and bone.The main function of a bursa is to reduce
friction between adjacent moving structures.

20.  Anteriorly:
• Subcutaneous pre - patellar
• Subcutaneous infra- patellar bursa
• Deep infra-patellar bursa
• Supra-patellar bursa

21.  Laterally:
• Between lateral head of gastrocnemius
& the capsule
• Between tendon of biceps femoris &
fibular collateral ligament
• Between fibular collateral ligament &
tendon of popliteus muscle
• Between tendon of popliteus & lateral
condyle of tibia.

22.  Medially:
• Medial head of gastrocnemius
& the capsule
• Superficial part of tibial
collateral ligament, sartorius,
gracilis and semitendinosus
• Superficial & deep part of tibial
collateral ligament
• Semi-membranosus & medial
condyle of tibia.

23. RELATIONS OF KNEE JOINT:
• Anteriorly : Quadriceps femoris
• Antero-medially : Medial patellar retinaculum
• Antero-laterally : Lateral patellar retinaculum & iliotibial tract
• Postero-medially : Sartorius, gracilis, semimembranosus & semitendinosus
• Postero-laterally :Tendon of biceps femoris & common peroneal nerve
• Posteriorly : Popliteal vessels, tibial nerve, both head of gastrocnemius &
plantaris

24. BLOOD SUPPLY :
• Descending genicular branch of femoral artery
• Descending branch of lateral circumflex femoral artery
• Genicular branches of popliteal artery
• Recurrent branches of anterior tibial artery
• Circumflex fibular branch of posterior tibial artery

25. NERVE SUPPLY :
 From femoral nerve:
• Nerve to the vasti
 Three from the tibial nerve:
• Superior medial Genicular
• Inferior medial genicular
• Middle genicular nerve
Three from the common peroneal nerve:
Superior lateral Genicular
Inferior lateral genicular
Recurrent genicular nerve

26. MOVEMENTS ATTHE KNEE JOINT:
• Active movements performed at the knee joint are:
 Extension:
• Extension or straightening continues until leg & thigh are in the same
vertical lines
• Extension is produced by Quadriceps femoris & assisted by tensor fascia
latae

27.  Flexion:
• Prime movers: semimembranosus, semitendinosus, biceps femoris
• Initiated by popliteus
• Assisted by, sartorius, gracilis, both head of gastrocnemius & plantaris
 Medial rotation:
• Semimembranosus, semitendinosus, popliteus, sartorius & gracilis
 Lateral rotation:
• Biceps femoris

28. LOCKING & UNLOCKING OFTHE KNEE JOINT :
• Locking is a mechanism that allows the knee to remain in the position of full
extension as in standing without much muscular effort.
• Locking occurs as a result of medial rotation of the femur during last stage of
extension.
• Locking is produced by Quadriceps femoris (Vastus medialis part )
• Unlocking occurs as a result of lateral rotation of the femur during initial
stage of flexion.
• Unlocking is produced by Popliteal muscle.

29. APPLIED ASPECT:
 Injuries to menisci:
• Most injured structures of the knee are tibial collateral ligament, the medial
menisci & ACL.
• Lateral aspect of the knee when the foot is on the ground may sprain the tibial
collateral ligament, the attached medial menisci may also be torn.
• Injuries to the menisci commonly occur in the flexed knee as a result of forcible
rotation or abduction.

30.  Inflammation of bursa-
• Housemaids knee - Subcutaneous pre-patellar bursa
• Clergyman's knee - Subcutaneous infra patellar bursa
• Osteoarthritis of knee joint
• Fracture of patella is a frequent problem