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KNEE JOINT ARTICULATING BONES

It is the largest  1. Lateral and 
and most medial
complicated joint in articulations
the body. between the tibial
condyles and their
cartilaginous
menisci and the
corresponding
femoral condyles.

FUNCTIONS ARTICULATING BONES

1. Weight bearing.  2. Intermediate 

2.Essential for daily  articulation

activities: standing between the
walking & climbing patella and femur.
stairs.
3.The main joint 
responsible for sports:
running, jumping ,
kicking etc.

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THE FEMORAL CONDYLES TYPE

The medial  A synovial joint of the 

extends further hinge variety

forwards . between the medial
The lateral is  and lateral condyles
more oval. of the femur and the
The condyles are 
corresponding tibial
convex from front condyles with some
to back. degree of rotation.

TIBIAL CONDYLES TYPE

(PLATEAUS) are flat .  A synovial joint of the 

The medial is oval The  plane gliding variety

lateral is round.
The articular surfaces 
are covered with
hyaline cartilage.

between the patella
and the patellar
surface of the femur.

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CAPSULE CAPSULE
It is absent Anteriorly. 
(b) Inferior : 
It is 
Attached to the 
Replaced by :  tibia EXCEPT when
Quadriceps femoris  the tendon of
tendon. Popliteus crosses
Patella.  the bone.
Ligamentum patellae. 

CAPSULE EXTRACAPSULAR LIGAMENTS

Posteriorly : 
(a) Superior : 
Attached proximal to 
the articular margins
of the femoral
condyles and to the
intercondylar fossa.
It is deficient above 
the lateral condyle for
1. Ligamentum 
Patellae
It is the inter mediate 
part of the tendon of
quadriceps femoris .It
is supported by the
patellar retinaculi
(expansions from the
vasti)
They strengthen the 

the passage of capsule on each side.

tendon of popliteus.

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2. TIBIAL (MEDIAL)
4. OBLIQUE POPLITEAL
COLLATERAL
An expansion of 
A flat band.  the
Attachment:  Semimembranos
Above to the medial  us.
condyle of the femur. It strengthens 
Below to the medial  the capsule
surface of the shaft of posteriorly.
the tibia.
Firmly attached to the 

medial meniscus.

3. LATERAL (FIBULAR) INTRA CAPSULAR

COLLATERA STRUCTURES
Cord like.  1. CRUCIATE 

Attachment :  LIGAMENTS.
Above : lateral condyle of  2. MENISCI. 
the femur. 3. TENDON OF 

Below : head of the  POPLITEUS.

fibula.
Separated from the 
lateral meniscus by the
tendon of popliteus.

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CRUCIATE LIGAMENTS ANTERIOR CRUCIATE

They are the main bond  FUNCTION 
between the femur and Prevent posterior 
tibia throughout the displacement of the
joint’s movements. femur on the tibia
and the tibia from
They Cross each other  being pulled
within the joint cavity. anteriorly when the
They are named  knee joint is flexed.
Anterior and Posterior It is taught in 
according to their tibial hyper extension.
attachments.

ANTERIOR CRUCIATE POSTERIOR CRUCIATE

Tibial attachment : 
Tibial attachment : 
posterior inter condylar 
Anterior intercondylar 
area.
area.
Direction: 
Course : 
upward, forward and 
Upward, backward and 
medially.
laterally.
Femoral attachment: 
Femoral attachment: 
Anterior part of the 
Posterior part of medial 
lateral surface of the
surface of the lateral
medial condyle.
condyle.

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POSTERIOR CRUCIATE MENISCI

Function:  The upper concave 
prevents anterior  surfaces are in contact
displacement of with the femoral
the femur on the condyles.
tibia and the tibia
from being pulled The lower flat 
posteriorly when surfaces are in contact
the knee joint is with the tibial condyles.
flexed.
It is taught in 
hyper flexion.

MENISCI MENISCI
C shaped sheets of fibro 

cartilage. Functions : 
The peripheral border is 
1. Deepen the 
thick and attached to tibial articular
surfaces.
the capsule.
2. Act as cushions 
The inner border is thin 
between the two
and concave and forms bones.
a free edge.

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MEDIAL MENISCUS
Crescentic in 
shape.
More liable to 
injury due to its
attachment to the
medial collateral
ligament and to
the capsule.
It is relatively 
immobile.
LATERAL MENISCUS
More rounded in shape. 
Its anterior and posterior 
ends lie within the ends of
the medial meniscus.
Posteriorly it is separated 
from the fibular collateral
ligament by the tendon of
popliteus.
Less liable to injury. 
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INJURY OF THE MENISCI
The menisci are frequently 
injured especially in
footballers and cricketers.
The medial is torn three 
times more often than the
lateral.
The injury is produced by 
the rotation of the femur
on the tibia or the reverse
with the knee joint
partially flexed and carries
the weight of the body.
INJURY OF THE MENISCI
The torn part of the 
meniscus is wedged
between the tibial and
femoral condyles.
No further movement 
is allowed and the joint
is kept locked.
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SYNOVIAL MEMBRANE
It lines the lateral and 
medial parts of the
capsule.
Anteriorly : 
It forms the supra 
patellar bursa.
It is attached to the 
inter condylar area of the
tibia and to the lateral
and medial borders of
the patella.
SYNOVIAL MEMBRANE
It is reflected backward 
from the posterior
surface of the
ligamentum patellae to
form the Infrapatellar
fold.
The free borders of the 
fold are the Alar folds.
The space between these 
folds contains fat
(Infrapatellar pad of
fat).
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SYNOVIAL MEMBRANE
Posteriorly : 
It Passes out to 
surround the cruciate
ligaments.
It is continuous with the 
surface layer of the
menisci.
It covers the tendon of 
popliteus and forms a
bursa around it
(popliteal bursa).
It forms the 
semimembranosus
bursa.
ANTERIOR BURSAE
They are four : 
1. Suprapatellar : 
It is 3 fingerbreadths above 
the patella.
Always continuous with the 
joint cavity.
Held in position by the 
articularis genus muscle.
Accumulation of fluid in the 
joint causes excees fluid in
the bursa leading to floating
patella.
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ANTERIOR BURSAE POSTERIOR BURSAE (6)
2. Prepatellar 
If enlarged it causes 
(House Maid’s) bursa.
ANTERIOR BURSAE
3.Superficial 
Infrapatellar.
(PARSON’S bursa
4.Deep 
Infrapatellar.
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1. POPLITEAL 
Always continuous with 
the joint cavity.
2.SEMIMEMBRANOSU 
Usually communicates 
with the joint cavity.
3 & 4. 
GASTROCNEMIUS
Around sartorius,gracilis 
and semitendinosus.
MOVEMENTS
1. FLEXION 
Hamstrings( 
supplied by the
sciatic nerve).
Assisted by sartorius, 
popliteus and
gracilis.
Checked by back of •
calf in contact with the
back of the thigh.
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MOVEMENTS NERVE SUPPLY

2. EXTENSION • Femoral. 
Quadriceps Femoris • Obturator. 
(supplied by the femoral Sciatic. 
nerve.) Common peroneal. 
Limited by tension of the • Tibial. 
cruciate and collateral
ligaments.

MOVEMENTS UNLOCKING
At the commencement of 
3. ROTATION • Flexion of the extended
(A) MEDIAL: • knee.
Sartorius, gracilis and Aim : 
semitendinosus. To slack the ligaments 
(B) LATERAL : • especially the cruciate.
Biceps femoris FEMUR: Lateral rotation 
(the foot is on the ground)
TIBIA: Medial rotation. 
Muscle: POPLITEUS 

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LOCKING RELATIONS
The joint assumes the 
Posterior : 
position of full extension.
Boundaries and 
It becomes a rigid  contents of
structure. Popliteal Fossa.
The menisci are  Medial : 
compressed between the SGS muscles. 
tibial and femoral condyles. Lateral : 
Tightening of all the major  Biceps femoris and 
ligaments. common peroneal
The femur is medially  nerve.
rotated on the tibia.

RELATIONS STABILITY
Anterior :  1. Muscles : 
Prepatellar bursa.  QUADRICEPS 
particularly the inferior
fibers of the vasti
lateralis and medialis.
Many sport injuries 
can be preventable
through appropriate
training and
conditioning of the
muscle.

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STABILITY ANTERIOR CRUCIATE INJURY

2. Ligaments :  Tear of the 
The knee joint can  anterior cruciate
function well following ligament is more
a ligamentous strain if common than the
the quadriceps is posterior.
intact. The tibia can be 
pulled excessively
forward on the
femur

INJURY OF THE JOINT POSTERIOR CRUCIATE INJURY

TRIAD OF INJURY  The tibia can be 
1. Medial collateral  pulled excessively
ligament. backward on the
2. Medial meniscus. 
femur.
3. Anterior cruciate 

ligament.
The joint becomes 
swollen because it is
filled with blood
(hemarthrosis).

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INJURY OF THE CRUCIATE ANKLE JOINT CONT’D

LIGAMENTS CAPSULE 

Management :  Encloses the joint and 

Knee is kept 
immobilized in slight
flexion.
Active physiotherapy 
of the quadriceps
femoris at once.
attached near the
articular margins except
anteriorly where
anteriorly it is attached
to the neck of the talus
in front of the articular
edge.
It is thin in front and 

Operative repair  behind.

(incase of torn of the Posteriorly it fuses with 

capsule and collateral the inferior transverse

ligaments). tibiofibular ligament.

SYNOVIAL MEMBRANE
ANKLE JOINT
TYPE 
Lines the capsule. 
Hinge synovial 
ARTICULATING 
Reflected anteriorly 
BONES on to the neck of
1. Lower end of the 
the talus as far as
tibia
2. Two malleoli. 
the articular
3. Body of the talus.  cartilage.
4. The inferior  May extend a short 
transverse
tibiofibular ligament distance between
deepens the socket the tibia and fibula.
for the body of the
talus.

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LIGAMENTS
MEDIAL( DELTOID) 
LATERAL LIGAMENT 
Attached by its 
apex to the tip of Weaker than the 

the medial medial.

malleolus. It consists of three 

Composed of deep  bands

and superficial 1. ANTERIOR 
fibers. TALOFIBULAR
DEEP FIBERS 
Between the lateral 
Attached to the 
malleolus and the
non articular area
lateral surface of the
on the medial
surface of the talus.
body of the talus. 2. CALCANEOFIBULAR 

SUPERFICIAL From the tip of the

LIGAMENTS CONT’D
Sustentaculum tali.  3. POSTERIOR 

Plantar 
TALOFIBULAR
calcaneonavicular Between the lateral 

ligament. malleolus and the

Medial side of talus. 
posterior tubercle
of the talus.
Tuberosity of 

navicular bone.

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STABILITY OF THE JOINT MOVEMENTS

1. Shape of the articulating bones.  DORSIFLEXION 

2. Strength of the ligaments.  Tibialis anterior, extensors of the digits 

and big toe, peroneus tertius.

3.The surrounding tendons. 
LIMITED BY 

Tension of tendo calcaneus. 

Posterior fibers of the medial ligament. 

Calcaneofibular ligament. 

RELATIONS
PLANTAR FLEXION 

Tibialis posterior, peroneus (longus and 

brevis) gastrocnemius.
LIMITED BY 

Tension of opposing muscles. 

Anterior fibers of the medial ligament. 

Anterior talofibular ligament. 

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