knee joint

Chapter 2 The knee joint

Anatomy

1. The knee joint is one of the largest and most complex joints of the body.

2. It comprises three separate articulations: two tibiofemoral joints and the patellofemoral articulation.

3. It is a synovial, bicondylar hinge joint.

4. It has a thick capsule encapsulating all three joints which attaches to the articular margins.

5. The capsular ligaments comprise oblique popliteal ligament, the arcuate popliteal ligament and the ligamentum patellae.

6. All hinge joints have collateral ligaments. The knee joint has the tibial (medial) and fibular (lateral) collateral ligaments.

7. The intra-articular structures consist of the cruciate ligaments (anterior and posterior) and the menisci (medial and lateral).

8. The movements that take place at the knee joint are: extension and flexion. When the knee is flexed, axial rotation of the leg can be performed. These movements consist of lateral (external) rotation of the tibia on the femur and medial (internal) rotation of the tibia on the femur.

Ligaments

Table 2.1 Knee ligaments

Muscles

Extensors

Table 2.2 The extensors of the knee

Flexors

Table 2.3 The flexors of the knee

Medial (internal) rotators

Table 2.4 The medial (internal) rotators of the knee

Lateral (external) rotators

Table 2.5 The lateral (external) rotators of the knee

Measurement

Range of Movement

Flexion

Starting position:

Fig 2.2 Goniometric measurement of knee flexion.

The patient is positioned in half lying/supine lying on the plinth. Their hip is in neutral and their knee is in extension.

Goniometer axis:

The axis of the goniometer is placed over the lateral epicondyle of the femur.

Stationary arm:

This is parallel to the longitudinal axis of the femur, pointing towards the greater trochanter of the femur.

Moveable arm:

This is parallel to the longitudinal axis of the fibula, pointing towards the lateral malleolus of the fibula.

Command to patient:

‘Bend your knee up towards you so that your heel moves towards your buttock as much as possible.’

End position:

The hip and knee are flexed to the limit of motion. The heel is moved towards the buttock to the limit of knee flexion.

NB: It may be necessary to reposition the stationary and moveable arms of the goniometer prior to taking the reading, as they may have moved when the patient flexed their knee.

Tags: A Physiotherapists Guide to Clinical Measurement

Jun 4, 2016 | Posted by admin in MANUAL THERAPIST | Comments Off

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