insha ur rahman student of the DPT in KHIST

2. Insha ur
rahmanPresented To
Sir Idrees

3. KneeJoint

4.  Feature
It is the largest joint in the human body.
Most complex joint of the body .The Complexity is the result of Fusion of Two
joints in one.
1. Tibiofemoral joint ( Between the femur and tibia)
2. Patellofemoral joint (Between the femur and patella )
The fibula is not directly involved in the joint .

5.  Type
It is condylar Synovial joint, Incorporating Two condylar
joints between the condyles of Femur and Tibia .and One
Saddle Joint Between Femur and Patella.

6. Above
The rounded condyles of the femur
Below
The condyles of the Tabia and their menisci
In Front
Is the articulation between the lower end of the
Femur and Patella
The articular surfaces of the Femur , tabia and
Patella are covered by Hyline cartilages

7.  The Joint Capsule
The capsule is a thick, fibrous
structure that wraps around the knee
joint. Inside the capsule is the synovial
membrane which is lined by the
synovium, a soft tissue that secretes
synovial fluid when it gets inflamed and
provides lubrication for the knee

8. Ligament May Be Divided Into
1. Extracapsular ligaments
Those that lies out side the
capsule.
2. Intracapsular ligaments
Those that lies with in the capsule.
3. Capsular Ligaments
Those that are thickend part of the
capsule.

9.  Extracapsular ligaments
1. Ligamentum Patellae
2. Fibular Collateral or Lateral Collateral
3. Tibial collateral or Medial ligament
4. Oblique popliteal ligament

10.  About 7.5 cm long and 2.5 cm broad. Is the
continuation of the central portion of the
common tendon of the Quadriceps femoris
muscle.
Attached
above
to the lower border of the patella
Bellow
to the tibial tuberosity.
Rupture of the ligamentum patellae
Can occur when a sudden flexing force is
applied to the knee joint, when the Quadriceps
femoris muscle is actively contracting

11.  Cord like it is about 5 cm long and
attached above to the lateral Condyle of
the femur and below to the head of the
fibula.
 Forced adduction of the tibia on the
femur can result in injury to the lateral
collateral ligament (less common than
medial ligament injury)

12.  About 10 cm long and 1.25 cm
broad, it is Flat band is attached
above to the medial condyle of
the femur and below to the
medial surface of the shaft of the
tibia.

13.  Is a tendinous expansion derived
from the Semimembranosus
muscle.
 It strengthens the posterior aspect
of the capsule, and is attached to
the intercondylar line and lateral
condyle of the femur.

14.  Y-shaped, it is extends backwards
from the head of the fibula, arches
over the tendon of the popliteus.
 Medial limb
curves over the popliteus muscle to
join with oblique popliteal ligament.
 Lateral limb
ascends to blend with the capsule
near the lateral head of gastrocnemius
muscle.

15.  Between the anterior intercondylay area of the tibia and the
posterior part of the medial surface of the lateral femoral condyle.
Function
Prevent posterior displacement of the femur on the tibia.
In flexed knee, prevents the tibia from being pulled anteriorly.
1. Anterior cruciate
2. Posterior cruciate

16.  Attachments
1. Anterior cruciate From anterior part of intercondylar area
of tibia to posterior part of lateral condyle
of femur
2. Posterior cruciate From posterior part of intercondylayar
area of tibia to anterior part of medial
condyle of femur
 Function
Anterior Cruciate prevents posterior displacement of femur on tibia
Posterior cruciate prevents anterior displacement of the femur on tibia

17.  The menisci are C-shaped sheets of fibrocartilage.
 The upper surfaces are in contact with the femoral condyles.
 The lower surfaces are in contact with the tibial condyles.
 The outer border is thick and attached to the capsule.
 The inner border is thin and concave and form a free edge.
Function
 The menisci serve as shock absorber.
 They help to lubricating the joint cavity.
 Because of their supply ,help give rise to proprioceptive
impulses.

18.  Lines the capsule and is attached to the margins of the articular
surfaces.
 On the front and above the joint, it forms a pouch, which extends up
beneath the quadriceps femoris muscle for three fingerbreadths
above the patella, forming the Suprapatellar bursa.
 A bursa is interposed between the medial head of the gastrocnemius
and the medial femoral condyle and semimembranosus tendon; this
is termed the semimembranosus bursa. And it frequently
communicates with the synovial cavity of the joint.

19. There have 12 Bursae have been described around the knee.
 Four (4) Anterior
 Four (4) Lateral
 Four (4) Medial

20. 1. Suprapatellar bursa
Lies beneath the Quadriceps muscle and Communicates with
the joint cavity
2. Prepatellar bursa
Lies in the subcutaneous tissue between the skin and the front
of the lower half of the patella.(upper part of ligamentum patella)
3. Superficial infrapatellar bursa
Lies in the subcutaneous tissue between the skin and the front
of the lower part of the ligamentum patellae.
4. Deep infrapatellar bursa
Lies between ligamentum patellae and the tibia.

21. 1. A bursa deep to the lateral head of the gastrocnemius.
2. A bursa between the fibular collateral ligament and the biceps
femoris.
3. A bursa between the fibular collateral ligament and the tendon of
the popliteus.
4. A bursa between the tendon of the popliteus and the lateral
condyle of the tibia.

22. 1. A bursa deep to the medial head of the gastrocnemius.
2. The anserine bursa is a complicated bursa which separates the
tendons of the sartorius, the gracilis and the semitendinosus from
the one another, from the tibia , and from the tibial collateral
ligament.
3. A bursa deep to the tibial collateral ligament.
4. A bursa deep to the semimembranosus.

23.  Anteriorly
Anterior bursae, ligamentum patellae and patellar plexus of
nerves.
 Posterorly
1. At the middle  popliteal vessels, tibial nerve.
2. Posterolaterally  lateral head of the gastrocnemius, plantaris and peroneal nerve.
3. Posteromedially  medial head of the gastrocnemius, semitendinosus, semimembranosus,
gracilis, and popliteus at its insertion.
Medially
1. Sartorius, gracilis and semitendinosus.
2. Great saphenous vein with saphenous nerve
3. Semimembranosus
Laterally
1. Biceps femoris, and the tendon of origin of popleteus.

24.  The femoral artery and the popliteal
artery help form the arterial network
or plexus, surrounding the knee
joint. There are six main branches:
two superior genicular arteries,
two inferio geniculararteries,
the descending genicular
artery and the recurrent branch of
anterior tibial artery.

25. 1. Femoral nerve, through its
branches to the vasti.
2. Sciatic nerve , therough the
genicular branches of Tibia and
Common peroneal nerves.
3. Obturator nerve, through its
posterior division.

26.  Flexion
Mainly by  Biceps femoris, Semitendinosus
Assisted by  Sartorius, Gracillis and popliteus muscles.
 Extension
Mainly by  Qusadriceps femoris muscle.
Assisted by  Tensor fasciae lata muscle
 Medial Rotation
Mainly by  Popliteus muscle
Assisted by Sartorius, gracillis, Semitendinosus and semimembranosus
 Lateral Rotation
Only done by the biceps femoris muscle

27. Locking is a mechanism that allows the knee to remain in the position
of full extension as in standing without mush muscle effort.
Mechanism
 The leg (tibia) is laterally rotated and the thigh (femur) is medially
rotated.
 This rotatory movememt locks the joint (which means that the joint cannot
be flexed unless it is unlocked by the reverse rotation)
 In full extension with the locked knee, all the ligament are stretched
and the joint is stable.
 Locking is produce by those muscle which produce extantion
(quardriceps femoris) especially the vastus medialis part.

28. Is the early stage of flexion of the knee joint.
Mechanism
 The leg is medially rotated and the thigh is laterally rotated
Muscles produce unlocking
1. Popliteus muscle
Helped by;
Semimembranosus, semitendinosus and gracillis muscle.

29. The knee doesn’t have much protection from trauma or stress
(pressure or force). In addition to wear and tear on the knee, sports
injuries are the source of many knee problems.
Symptoms
Knee symptoms come in many varieties. Pain can be dull, sharp,
constant or off-and-on. Pain can also be mild to agonizing. The range
of motion in the knee can be too much or too little.
Some knee problems only need rest and ice, others need physical
therapy (knee rehab exercises) or even surgery.

30. Swelling
One of the most common symptoms is local swelling. There
are two types of swelling. One is caused by the knee producing too
much synovial fluid and the other is caused by bleeding into the joint
(hemarthrosis). Swelling within the first hour of an injury is usually
from bleeding.
The best home treatment for swelling is R.I.C.E. therapy.