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Knee joint
1.
2. MOVEMENTS
LOCKING AND UNLOCKING OF THE
KNEE JOINT
By M.Aravind
MBBS Ist year
DSMCH
Perambalur
MOVEMENTS
LOCKING AND UNLOCKING OF THE KNEE
JOINT
3. KNEE JOINT
It is the largest joint of
the body
It is formed between
lower end of femur,
upper end of tibia and
patella
The condyles of femur
The patella
The condyles of tibia
ARTICULARSURFACES
4. Type
A modified hinge type of synovial joint (as
some degree of rotation takes place during
locking and unlocking of the joint.
Weak joint
Articular surfaces are not congruent
Tibial condyles are shallow
Femoropatellar articular surfaces are shallow
Outward angulation between the long axis of
leg and knee
5. Strength of the
knee joint
Cruciate ligaments maintain
anteroposterior stability
Collateral ligaments maintain
side to side stability
Capsule is strengthened by
Anterior- medial and lateral
patellar retinacula
Posterior- oblique popliteal ligament
Medial- expansions from tendons
of sartorius and semitendinosus
Lateral- illiotibial tract
6. Complexity of the joint
The joint consists of two
parts
Condylar synovial joint-
between two femoral
condyles and tibial
condyles
Saddle joint- between the
lower end of femur and
patella
7. Movements at the knee joint
Flexion and extension Medial and lateral rotation
Chief movements
Takes place in upper
compartment of the joint,
above the menisci
Takes place around
transverse axis
Small range of movements
Takes place in the lower
compartment of the joint,
below the menisci
Takes place around vertical
axis
8.
9. During different phases of movements of
knee different portions of patella articulate
with the femur.
Extension- lower pair of articular facets
Beginning of flexion- middle pair
Midflexion-upper pair
Full flexion-
medial strip
12. Have you ever noticed thatYou stand for a
long time without much muscular effect. How
is it possible?
It is due to locking mechanism of knee joint
13. LOCKING OF KNEE JOINT
The anteroposterior diameter of the lateral
femoral condyle is less than that of the
medial condyle.
Therefore the lateral condylar surface is fully
used up
It serves as the axis around which the medial
condyle rotates medially so that the
remaining part is used up.
All the ligaments of the knee joint are taut.
14. Locking Unlocking
During last 30 degrees of
extension
Medial rotation of femur
Helped by quadriceps femoris
(mainly vastus medialis)
As standing at attention
The ligaments are taut
During initial stages of flexion
Lateral rotation of femur
Helped by popliteus
As standing at ease
The ligaments are relaxed
15. Accessory or passive movements
performed in a partially flexed
knee
A wider range of rotation
Anteroposterior gliding of the tibia on the
femur
Some adduction and abduction
Some seperation of the tibia from the femur
16. CLINICAL ANATOMY
OSTEOARTHIRITIS
CONDITION-Degeneration
of the articular surfaces
CAUSES- Ageing,congenital deformity, fracture
around the knee joint
DEFORMITY- Limited movements, pain
BAKER’S CYST- Synovial membrane protrudes
through a hole in the posterior surface of the
knee joint, central swelling
SYMPTOMS: Knee pain, stiffness, swelling
17. KNEE REPLACEMENT
TREATMENT
In the past such
patients had to depend
on heavy doses of
analgesics to relieve
pain
Now the entire joint
can be replaced using
artificial materials
giving long lasting
relief to many
18.
19. DEFORMITIES OF THE KNEE
GENUMVALGUM OR KNOCK
KNEE
GENUMVARUM OR BOW
KNEE
LEG MAY BE
ABNORMALLY
ABDUCTED
LEG MAY BE
ABNORMALLY
ADDUCTED
CAUSES
RICKETS
POSTURE
CONGENITAL ABNORMALITY
20.
21. DISLOCATION OF THE KNEE
JOINT
Rare
Results in damage to
Poplital artery
Tibial nerve or
Common peroneal nerve
22. INJURIES IN THE REGION OF
KNEE JOINT
TRAUMATIC SYNOVITIS- joint cavity filled
with serous fluid
HAEMARTHROSIS- joint filled with blood
RHEUMATOIDARTHIRITIS- autoimmune
condition
GOUT- deposition of sodium urate crystals
PSEUDOGOUT- deposition of calcium
phosphate crystals
SEPTIC ARTHIRITIS- bacterial infection
23. KNEE TESTS
ARTHROSCOPY
Arthroscopy involves the introduction of a
lighted instrument into the synovial cavityof
the knee joint through a small incision.The
technique permits the direct visualization of
structures such as the cruciate ligaments and
the menisci for diagnostic purposes.
Parts of torn menisci (ligaments) and other
parts of loose tissue can be removed
KNEE X-RAY
MAGNETIC RESONANCE IMAGING-
ligamental and meniscal injury
24. PNEUMOARTHROGRAPHY
Air can be injected into the synovial cavity of
the knee joint so that the soft tissues can be
studied.This technique is based on the fact
that air is less radiopaque than structures the
medial and lateral menisci, so their outline
can be visualized on a radiograph