KNEE COMPLEX
-: Introduction :- <ul><li>Tibiofemoral  joint </li></ul><ul><li>Patellofemoral  joint </li></ul><ul><li>Structure  of  th...
Tibio femoral alignment and weight-bearing forces <ul><li>Mechanical Axis </li></ul><ul><li>Medial valgus angle </li></ul>...
<ul><li>Genu Valgus  </li></ul><ul><li>Genu Varus </li></ul>
Menisci <ul><li>Menisci Attachement </li></ul><ul><li>Role of the menisci </li></ul><ul><li>Menisci nutrition </li></ul><u...
-: Joint capsule :- <ul><li>Attachments </li></ul><ul><li>Synovial layer of the joint capsule </li></ul><ul><li>Fibrous la...
-: Ligaments of knee joint :- <ul><li>Medial collateral ligament </li></ul><ul><li>Lateral collateral ligament </li></ul><...
Medial collateral ligament <ul><ul><li>Superficial portion ->   origin -: medial femoral epicondyle </li></ul></ul><ul><li...
-: Lateral collateral ligament :- <ul><li>Lat. Side of tibiofemoral joint </li></ul><ul><li>Proximally from lat. Femoral c...
-: Anterior Cruciate ligament :- <ul><li>Attached to ant. Tibial spine </li></ul><ul><li>sup  and  post.  attached to post...
-: Posterior cruciate ligament :- <ul><li>Attached distally to the posterior tibial spine & Anteriorly attached to lat. As...
1. prevent Excessive knee extension  -: Role of ligaments :- 3. prevent ant. &post. Displacement of  tibia med.&lat. Rotat...
-: Iliotibial band :- <ul><li>Proximally fascia investing  TFL,  gluteus maximus &medius muscle </li></ul><ul><li>Distally...
-: Bursae :- <ul><li>Set up potential for substantial frictional among muscular,bony structure, </li></ul><ul><li>numerous...
-: TIBIOFEMORAL JOINT FUNCTION :- <ul><li>JOINT  KINEMATICS </li></ul><ul><li>Flexion / Extension </li></ul><ul><li>Medial...
-: MUSCLES :- <ul><li>Knee Flexor Group </li></ul><ul><li>Semimembranosus </li></ul><ul><li>Semitendinosus </li></ul><ul><...
<ul><li>Knee Extensor Group </li></ul><ul><li>Quadriceps Femoris </li></ul><ul><li>Rectus Femoris </li></ul><ul><li>Vastus...
-: STABILIZERS OF KNEE :- <ul><li>A-P/hyperextension stabilizers </li></ul><ul><li>Varus / Valgus stabilizers </li></ul><u...
<ul><li>Largest sesamoid bone. </li></ul><ul><li>Its function is to increase leverage of quadriceps muscle. </li></ul><ul>...
Patellar articular surface  area & joint congruency <ul><li>In knee extension </li></ul><ul><li>At mid range of flexion </...
-: Motions of patella :- 1.Patellar flexion 2.Patellar extension 3.Medial patellar tilt 4.Lateral patellar tilt 5.Medial r...
-: Patellofemoral joint stress :- <ul><li>Patellofemoral joint reaction  </li></ul><ul><li>force in </li></ul>1.Knee flexi...
Frontal plane patellofemoral joint stability 1.Longitudinal stabilizers 2.Transverse stabilizers <ul><li>Quadriceps inhibi...
<ul><li>No bony stabilization </li></ul>1.Longitudinal stabilizers Quadriceps and patellar tendon ( patellotibial tendon )...
Quadriceps inhibition <ul><li>Patellar tendon injury </li></ul><ul><li>Quadriceps atrophy </li></ul><ul><li>VMO weakness <...
Asymmetry of patellofemoral stabilization Q- angle <ul><li>Defination </li></ul><ul><li>In male and female </li></ul><ul><...
-: Weight bearing versus Non-weight bearing exercises with Patellofemoral pain :-
Effects of injury and disease <ul><li>Tibiofemoral joint injury </li></ul><ul><li>Patellofemoral joint injury </li></ul><u...
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Knee complex

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  • Knee complex

    1. 1. KNEE COMPLEX
    2. 2. -: Introduction :- <ul><li>Tibiofemoral joint </li></ul><ul><li>Patellofemoral joint </li></ul><ul><li>Structure of the tibiofemoral joint. </li></ul><ul><li>Type – Double condyloid </li></ul><ul><li>Articulating surface </li></ul><ul><li>Femur </li></ul><ul><li>Tibia </li></ul>
    3. 3. Tibio femoral alignment and weight-bearing forces <ul><li>Mechanical Axis </li></ul><ul><li>Medial valgus angle </li></ul><ul><li>Anatomic axis </li></ul>
    4. 4. <ul><li>Genu Valgus </li></ul><ul><li>Genu Varus </li></ul>
    5. 5. Menisci <ul><li>Menisci Attachement </li></ul><ul><li>Role of the menisci </li></ul><ul><li>Menisci nutrition </li></ul><ul><li>Menisci innervation </li></ul>
    6. 6. -: Joint capsule :- <ul><li>Attachments </li></ul><ul><li>Synovial layer of the joint capsule </li></ul><ul><li>Fibrous layer of the joint capsule </li></ul>
    7. 7. -: Ligaments of knee joint :- <ul><li>Medial collateral ligament </li></ul><ul><li>Lateral collateral ligament </li></ul><ul><li>Ant. Cruciate ligament </li></ul><ul><li>Post. Cruciate ligament </li></ul>
    8. 8. Medial collateral ligament <ul><ul><li>Superficial portion -> origin -: medial femoral epicondyle </li></ul></ul><ul><li>Insertion -: med. Aspect of proximal tibia </li></ul><ul><li>Restrain to excessive abduction (valgus)&lat. Rotation stresses at knee </li></ul><ul><li>Deep portion-> </li></ul><ul><li>Origin-: inf. Aspect of med. Femoral condyle </li></ul><ul><li>Insetion-:proximal aspect of med. Tibia </li></ul>
    9. 9. -: Lateral collateral ligament :- <ul><li>Lat. Side of tibiofemoral joint </li></ul><ul><li>Proximally from lat. Femoral condyle </li></ul><ul><li>Fibular head </li></ul><ul><li>where it joins with tendon of biceps femoris </li></ul><ul><li>Responsible for checking varus stresses </li></ul>
    10. 10. -: Anterior Cruciate ligament :- <ul><li>Attached to ant. Tibial spine </li></ul><ul><li>sup and post. attached to posteromedial aspect of lat. Femoral condyle </li></ul><ul><li>Anteromedial band </li></ul><ul><li>Posterolateral band </li></ul>
    11. 11. -: Posterior cruciate ligament :- <ul><li>Attached distally to the posterior tibial spine & Anteriorly attached to lat. Aspect of med. Femoral condyle </li></ul><ul><li>restrain post. Displacement </li></ul>
    12. 12. 1. prevent Excessive knee extension -: Role of ligaments :- 3. prevent ant. &post. Displacement of tibia med.&lat. Rotation beneath the femur-both together called rotatery stabilization of tibia 2.Varus & valgus stresses at knee
    13. 13. -: Iliotibial band :- <ul><li>Proximally fascia investing TFL, gluteus maximus &medius muscle </li></ul><ul><li>Distally atteched intermuscular septum &inserted anterolateral tibia </li></ul><ul><li>Contraction of tfl &gluteus muscle attach to it band –produce minimal longitudinal excursion of band </li></ul><ul><li>Fibrous connection of it band -assisted ACL ------}checking posterior femoral translation –full extension </li></ul><ul><li>Increase the stability of lat. Side of joint </li></ul>
    14. 14. -: Bursae :- <ul><li>Set up potential for substantial frictional among muscular,bony structure, </li></ul><ul><li>numerous bursa </li></ul><ul><li>Three type </li></ul><ul><li>1.Suprapatellar bursae </li></ul><ul><li>2.Subpopliteal “ </li></ul><ul><li>3.gastrocnemius “ </li></ul><ul><li>Infrapatellar bursae….It separated by synovial cavity of jt by infrapatellar fat pad </li></ul>
    15. 15. -: TIBIOFEMORAL JOINT FUNCTION :- <ul><li>JOINT KINEMATICS </li></ul><ul><li>Flexion / Extension </li></ul><ul><li>Medial / Lateral </li></ul><ul><li>Rotation </li></ul><ul><li>Varus / Valgus </li></ul><ul><li>Coupled Motions </li></ul>
    16. 16. -: MUSCLES :- <ul><li>Knee Flexor Group </li></ul><ul><li>Semimembranosus </li></ul><ul><li>Semitendinosus </li></ul><ul><li>Biceps Femoris (Long and short heads) </li></ul><ul><li>Sartorius </li></ul><ul><li>Gracilis </li></ul><ul><li>Popliteus </li></ul><ul><li>Gastrocnemius </li></ul>
    17. 17. <ul><li>Knee Extensor Group </li></ul><ul><li>Quadriceps Femoris </li></ul><ul><li>Rectus Femoris </li></ul><ul><li>Vastus Medialis </li></ul><ul><li>Vastus Intermedius </li></ul><ul><li>Vastus Lateralis </li></ul>
    18. 18. -: STABILIZERS OF KNEE :- <ul><li>A-P/hyperextension stabilizers </li></ul><ul><li>Varus / Valgus stabilizers </li></ul><ul><li>Internal / External rotational stabilizers </li></ul>
    19. 19. <ul><li>Largest sesamoid bone. </li></ul><ul><li>Its function is to increase leverage of quadriceps muscle. </li></ul><ul><li>Patella is triangular with apex directed downwards </li></ul><ul><li>Anterior surface of the patella is gently convex </li></ul><ul><li>The joint surfaces are not very congruent. Upper3/4th part of the posterior surface is articular </li></ul><ul><li>Articular surface has a convex medial facet and a concave lateral facet </li></ul>-: Anatomy of the patella :-
    20. 20. Patellar articular surface area & joint congruency <ul><li>In knee extension </li></ul><ul><li>At mid range of flexion </li></ul><ul><li>At 90 degree of flexion </li></ul><ul><li>Beyond 90 degree of flexion </li></ul>
    21. 21. -: Motions of patella :- 1.Patellar flexion 2.Patellar extension 3.Medial patellar tilt 4.Lateral patellar tilt 5.Medial rotation 6.Lateral rotation 7.Patellar translation 8.Patellar shift
    22. 22. -: Patellofemoral joint stress :- <ul><li>Patellofemoral joint reaction </li></ul><ul><li>force in </li></ul>1.Knee flexion 2.Knee extension <ul><li>Influence of amount of knee flexion and contact surface between patella and femur </li></ul><ul><li>Joint reaction forces in daily living activity </li></ul><ul><li>Patella as anatomical pulley </li></ul><ul><li>Contact forces in vertical position of patella </li></ul>
    23. 23. Frontal plane patellofemoral joint stability 1.Longitudinal stabilizers 2.Transverse stabilizers <ul><li>Quadriceps inhibition </li></ul><ul><li>Asymmetry of patellofemoral stabilization </li></ul><ul><li>stabilizers </li></ul>
    24. 24. <ul><li>No bony stabilization </li></ul>1.Longitudinal stabilizers Quadriceps and patellar tendon ( patellotibial tendon ) 2.Transverse stabilizers Superior portion of extensior retinaculum Vastus lateralis and medialis Medial and lateral patellofemoral ligament <ul><li>Trochlear dysplasia </li></ul>Stabilizers
    25. 25. Quadriceps inhibition <ul><li>Patellar tendon injury </li></ul><ul><li>Quadriceps atrophy </li></ul><ul><li>VMO weakness </li></ul><ul><li>Limiting motion of patella </li></ul>
    26. 26. Asymmetry of patellofemoral stabilization Q- angle <ul><li>Defination </li></ul><ul><li>In male and female </li></ul><ul><li>Problem with Q-angle </li></ul><ul><li>Another abnormalities </li></ul>
    27. 27. -: Weight bearing versus Non-weight bearing exercises with Patellofemoral pain :-
    28. 28. Effects of injury and disease <ul><li>Tibiofemoral joint injury </li></ul><ul><li>Patellofemoral joint injury </li></ul><ul><li>Injury to menisci </li></ul><ul><li>Injury to Ligament </li></ul><ul><li>Injury to Bone </li></ul><ul><li>Patellar dislocaltion </li></ul><ul><li>Causes of patellar dislocation </li></ul>

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