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Overview of the Knee Anatomy
Bones of the Knee
Femur: Thigh bone, forms the upper part of the knee joint.
Tibia: Shinbone, supports most of the weight.
Fibula: Smaller bone next to the tibia, provides stability to the ankle and supports muscles.
Patella: Knee cap, protects the knee joint.
Ligaments
Anterior Cruciate Ligament (ACL): Prevents forward movement of the tibia.
Posterior Cruciate Ligament (PCL): Prevents backward movement of the tibia.
Medial Collateral Ligament (MCL): Stabilizes the inner knee.
Lateral Collateral Ligament (LCL): Stabilizes the outer knee.
Menisci
Medial Meniscus: C-shaped cartilage on the inner side.
Lateral Meniscus: C-shaped cartilage on the outer side.
Femur Anatomy
Patellar Surface: The area on the femur that interacts with the patella.
Medial and Lateral Grooves: Channels for ligament attachment.
Epicondyles: Medial and Lateral epicondyles serve as attachment sites for ligaments.
Tibia and Fibula Anatomy
Tibia: Main weight-bearing bone of the lower leg.
Fibula: Lateral to the tibia; less weight-bearing and mainly provides muscle attachment.
Tibial Tuberosity: Point of attachment for the patellar tendon.
Cruciate Ligaments Structure
Characteristics: Form an X shape within the knee joint.
Quadriceps Muscles: Primary muscles that extend the knee; their tendon attaches to the patella.
Articular Cartilage: Covers the ends of bones in the knee joint to allow smooth movement.
Anterior Cruciate Ligament (ACL)
Location: Extends from the lateral femoral condyle to the anterior tibia.
Function: Resist anterior movement of the tibia.
Posterior Cruciate Ligament (PCL)
Location: Extends from the medial femoral condyle to the posterior aspect of the tibia.
Function: Resists posterior movement of the tibia.
Collateral Ligaments Functions
Lateral and Medial Bands: Resist valgus (MCL) and varus (LCL) deformities, maintaining knee stability during movement.
Valgus and Varus Deformities
Valgus Deformity (Knock-kneed): Lower leg is abducted from the midline of the body.
Varus Deformity (Bow-legged): Lower leg is adducted toward the midline.
Menisci Structure
Function: Two crescent-shaped pads between the tibia and femoral condyles, providing cushioning and stability.
Knee Injuries
Common Types: Tears of ligaments (ACL, PCL, MCL, LCL) or menisci.
Symptoms: Swelling, instability, and a sensation that the knee may give out.
ACL Injuries
Common Causes: Non-contact injuries during sports involving running, jumping, cutting, or pivoting.
Clinical Signs: Often sensed as a "pop" at the time of injury.
Tests: Anterior Drawer Test and Lachman Test to assess ACL integrity.
PCL Injuries
Common Causes: Often results from trauma, particularly a dashboard injury in vehicle accidents.
Tests: Posterior Drawer Sign to evaluate posterior tibial translation.
MCL Injuries
Causes: Valgus stress due to contact or twisting injuries.
Symptoms: Pain, swelling, and abnormal abduction of the knee.
Unhappy Triad Injury
Description: Common injury pattern in contact sports involving simultaneous injury of the ACL, MCL, and typically a meniscus (often the medial meniscus).
LCL Injuries
Characteristics: Rarely injured in isolation; often associated with medial knee trauma.
Meniscal Tears
Mechanism of Injury: Common during sports involving twisting movements with weight on the knee.
Symptoms: Pain, swelling, and limited range of motion.
Diagnostic Tests for Menisci
McMurray Test: Detects meniscal tears by flexing and extending the knee while rotating the foot.
Bursitis of the Knee
Types: Prepatellar Bursitis (Housemaid’s knee) may arise from repetitive kneeling.
Baker's Cyst**
Description: Accumulation of fluid in the popliteal area, often related to joint disease or injury.
Osgood-Schlatter Disease
Characteristics: Overuse condition in children causing pain at the tibial tuberosity.
Patellar Fractures
Description: Result from trauma, often indicated by inability to extend the knee against gravity.
Conclusion
Knee Health: Understanding the anatomy and common injuries is crucial for effective injury prevention and treatment.