ANATOMY OF KNEE

JOINT
 The knee joint is our largest and most superficial joint. It is
primarily a hinge type of synovial joint, allowing flexion
and extension; however, the hinge movements are
combined with gliding and rolling and with rotation about a
vertical axis.
The knee joint consists of three articulations:
Two femorotibial articulations (lateral and medial)
between the lateral and the medial femoral and tibial
condyles.
One intermediate femoropatellar articulation between the
patella and the femur.
The most important muscle in stabilizing the knee joint is
the large quadriceps femoris, particularly the inferior fibers
of the vastus medialis and lateralis
JOINT CAPSULE OF KNEE JOINT

The joint capsule of the knee joint is typical in consisting

of an external fibrous layer of the capsule (fibrous
capsule) and an internal synovial membrane that lines all
internal surfaces of the articular cavity not covered with
articular cartilage.
EXTRACAPSULAR LIGAMENTS OF KNEE JOINT

The joint capsule is strengthened by five extracapsular or

capsular (intrinsic) ligaments: patellar ligament, fibular
collateral ligament, tibial collateral ligament, oblique
popliteal ligament, and arcuate popliteal ligament. They are
sometimes called external ligaments to differentiate them
from internal ligaments, such as the cruciate ligaments.
The patellar ligament, the distal part of the quadriceps
tendon, is a strong, thick fibrous band passing from the apex
and adjoining margins of the patella to the tibial tuberosity
The fibular collateral ligament (FCL; lateral collateral
ligament), a cord-like extracapsular ligament, is strong. It
extends inferiorly from the lateral epicondyle of the femur to
the lateral surface of the fibular head.
 The tibial collateral ligament (TCL; medial collateral
ligament) is a strong, flat, intrinsic (capsular) band that
extends from the medial epicondyle of the femur to the
medial condyle and the superior part of the medial surface
of the tibia
The oblique popliteal ligament is a recurrent expansion of
the tendon of the semimembranosus that reinforces the joint
capsule posteriorly as it spans the intracondylar fossa
The arcuate popliteal ligament also strengthens the joint
capsule posterolaterally. It arises from the posterior aspect
of the fibular head, passes superomedially over the tendon
of the popliteus, and spreads over the posterior surface of
the knee joint.
INTRA-ARTICULAR LIGAMENTS OF KNEE JOINT

The intra-articular ligaments within the knee joint consist of the

cruciate ligaments and menisci.
The anterior cruciate ligament (ACL), the weaker of the two
cruciate ligaments, arises from the anterior intercondylar area of
the tibia, just posterior to the attachment of the medial meniscus
The posterior cruciate ligament (PCL), the stronger of the two
cruciate ligaments, arises from the posterior intercondylar area
of the tibia.The PCL passes superiorly and anteriorly on the
medial side of the ACL to attach to the anterior part of the lateral
surface of the medial condyle of the femur
The menisci of the knee joint are crescentic plates (wafers) of
fibrocartilage on the articular surface of the tibia that deepen the
surface and play a role in shock absorption
MOVEMENTS OF KNEE JOINT

Flexion and extension are the main knee movements;

some rotation occurs when the knee is flexed.
When the knee is fully extended with the foot on the
ground, the knee passively locks because of medial
rotation of the femoral condyles on the tibial plateau (the
screw-home mechanism). This position makes the lower
limb a solid column and more adapted for weight-bearing.
When the knee is locked, the thigh and leg muscles can
relax briefly without making the knee joint too unstable. To
unlock the knee, the popliteus contracts, rotating the
femur laterally about 5 on the tibial plateau so that flexion
of the knee can occur.
BLOOD SUPPLY OF KNEE JOINT

The arteries supplying the knee joint are the 10 vessels

that form the periarticular genicular anastomoses around
the knee: the genicular branches of the femoral, popliteal,
and anterior and posterior recurrent branches of the
anterior tibial recurrent and circumflex fibular arteries. The
middle genicular branches of the popliteal artery penetrate
the fibrous layer of the joint capsule and supply the
cruciate ligaments, synovial membrane, and peripheral
margins of the menisci.
INNERVATION OF KNEE JOINT

Reflecting Hilton's law, the nerves supplying the muscles

crossing (acting on) the knee joint also supply the joint
,thus articular branches from the femoral (the branches to
the vasti), tibial, and common fibular nerves supply its
anterior, posterior, and lateral aspects, respectively. In
addition, however, the obturator and saphenous
(cutaneous) nerves supply articular branches to its medial
aspect.
Bursae around knee joint
Four bursae communicate with the synovial cavity of the
knee joint: suprapatellar bursa, popliteus bursa (deep to
the distal quadriceps), anserine bursa (deep to the
tendinous distal attachments of the sartorius, gracilis, and
semitendinosus), and gastrocnemius bursae. The large
suprapatellar bursa is especially important because an
infection in it may spread to the knee joint cavity. Although
it develops separately from the knee joint, the bursa
becomes continuous with it.
THANK YOU