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KNEE JOINT
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KNEE ANKLE KNEE JOINT ARTICULATION Between the condyles of the
femur and the condyles of the tibia. Anteriorly, an articulation
between the lower end of the femur and the patella. Prof. Makarem
TYPE Between the femur & the tibia it is a
Synovial modified hinge joint, with some degree of rotatory
movement. The joint between the femur and patella is a synovial
plane gliding joint. Prof. Makarem CAPSULE Attached to the margins
of the articular surfaces and surrounds the sides and the posterior
aspect of the joint. Prof. Makarem The capsule is absent
anteriorlly.
It is replaced anteriorly by the quadriceps tendon, patella &
Ligamentum patellae. Prof. Makarem The capsule is strengthened on
each side of the patella by expansions of the tendons of vastus
lateralis and medialis and posteriorly by the expansion of the
semimemranous muscle (oblique popliteal ligament). Prof. Makarem
SYNOVIAL MEMBRANE Attached to the margins of the articular
surfaces.
Lines the interior of the capsule. Forms several bursae around the
joint. Prof. Makarem EXTRACAPSULAR LIGAMENTS
Ligamentum patellae: between the lower border of the patella &
the tuberosity of the tibia. It is a continuation of the tendon of
quadriceps femoris. Lateral collateral ligament: between the
lateral condyle of femur and the head of the fibula. Medial
collateral ligament: between the medial condyle of the femur and
medial side of the shaft of the tibia (behind SGS). Firmly attached
to the edge of the medial meniscus. Prof. Makarem Oblique popliteal
ligament: strengthens the posterior side of the capsule.
Prof. Makarem Anterior cruciate ligament:
INTRACAPSULAR LIGAMENTS CRUCIATE LIGAMENTS Anterior cruciate
ligament: Between the anterior intercondylar area of the tibia and
the posterior part of the medial surface of the lateral femoral
condyle. Function: prevents posterior displacement of the femur on
the tibia. In flexed knee, prevents the tibia from being pulled
anteriorly. Prof. Makarem Posterior cruciate ligament:
Between the posterior intercondylar area of the tibia and the
anterior part of the lateral surface of the medial femoral condyle.
Function: prevents anterior displacement of the femur on the tibia.
In flexed knee, prevents the tibia from being pulled posteriorly.
Prof. Makarem MENISCI C-shaped intracapsular ligaments. Prof.
Makarem The peripheral border is thick and attached to the capsule,
the inner border is thin and free.
Each meniscus is attached to the upper surface of the tibia by
anterior and posterior horns. The medial meniscus is firmly
attached to the medial collateral ligament. Prof. Makarem Function:
to deepen the articular surface of the tibial condyles and to serve
as shock absorber.
Prof. Makarem 3- Superficial infrapatellar:
BURSAE ANTERIOR 1- Suprapatellar: beneath the quadriceps femoris.
2- Prepatellar: between the skin and the patella. 3- Superficial
infrapatellar: beween the skin and the lower part of ligamentum
patellae. 4- Deep infrapatellar: between ligamentum patellae and
the tibia. Prof. Makarem POSTERIOR 1- Popliteal: beneath the tendon
of popliteus muscle
2- Semimembranous: under the tendon of semimembranous muscle Prof.
Makarem MOVEMENTS Flexion: biceps femoris, semitendinosus and
semimembranosus, assisted by gracilis, sartorius and popliteus.
Limited by contact with the back of thigh. Extension: quadriceps
femoris. Limited by tension of the joint ligaments. Medial
rotation: sartorius, gracilis and semitendinosus. Lateral rotation:
biceps femoris. Stability of the joint: dependent on the tone of
the muscles and the strength of the ligaments. Prof. Makarem It is
necessary to start flexion.
Locked position: in full extension, the femur is medially rotated,
producing tightening of all of the ligaments and compression of the
menisci. Unlocking: by contraction of the popliteus muscle,
producing lateral rotation of the femur. It is necessary to start
flexion. Prof. Makarem INJURIES Common injury: when the knee is
twisted while running
Prof. Makarem ARTHROSCOPY Prof. Makarem BURSITIS Prof. Makarem
ANKLE JOINT ARTICULATION Between the distal end of the tibia, the
two malleoli and the body of the talus. Type: synovial hinge joint.
Prof. Makarem Medial (deltoid) ligament:
LIGAMENTS Medial (deltoid) ligament: from the tip of the medial
malleolus to: 1- talus, 2- plantar calcaneonavicular ligament and
3- tuberosity of the navicular bone. Prof. Makarem anterior
talofibular ligament:
Lateral ligament: 3 bands anterior talofibular ligament: from the
lateral malleolus to the lateral surface of the talus.
calcaneofibular ligament: from the lateral malleolus to the lateral
surface of the calcaneum. posterior talofibular ligament: from the
lateral malleolus to the posterior tubercle of the talus. Prof.
Makarem MOVEMENTS Dorsiflexion: Tibialis anterior, Extensor
hallucis longus,
3. Extensor digitorum longus and Peroneus tertius. Plantar flexion:
Gastrocnemius, Soleus, Plantaris, Peroneus longus, Peroneus brevis,
Tibialis posterior, Flexor digitorum longus and Flexor hallucis
longus. Prof. Makarem MEDICAL IMAGING Prof. Makarem INJURIES
Sprained ankle: Usually inversion injury.
Severe sprains lead to torn lateral ligament and fracture of the
lateral malleolus and result in instability of the ankle joint.
Prof. Makarem