Knee

Question 1

Classify the tibiofemoral joint

Answer 1

Synovial, compound, complex, unmodified ovoid, 3 degrees of motion

Question 2

What are the medial ligaments of the tibiofemoral joint

Answer 2

MCL - deep and superficial. Posterior oblique ligament (posterolateral support)

Question 2

What structures provide lateral support to the tibiofemoral joint

Answer 2

LCL, ITB, arcuate ligament, popliteofibular ligament, fabellofibular ligament

Question 2

How many degrees of motion does the superior tib-fib joint have?

Answer 2

3 DOM

Question 3

Classify the superior tibiofibular joint

Answer 3

Synovial
Simple
Planar (though some variation)

Question 4

What movements does the ACL restrain

Answer 4

Ant. tibial translation, external tibial rotation with knee flexion

Question 4

Osteokinematics of the superior tib-fib joint (with knee flex/extn and ankle DF/PF during WB)

Answer 4

Knee flex - Anterior

Knee extn - Posterior

Ankle DF - anterolateral, superior, IR (variable)

Ankle PF - posteromedial, inferior, ER (variable)

Question 5

What movements does the PCL restrain

Answer 5

Posterior tibial translation, external tibial rotation

Question 5

Arthrokinematics

Answer 5

As for osteokinematics

Question 6

Does the lateral meniscus attach the to LCL

Answer 6

No

Question 6

Articular surfaces of TIBIA in superior tib-fib joint (location, direction, surface description)

Answer 6

Location: posterior, inferior, lateral from the lateral condyle of the tibia

Direction: posterior, inferior, lateral

Description: small, circular facet

Question 7

Describe flexion and extension of the tibiofemoral joint osteokinematics

Answer 7

Impure swing around a transverse axis in a sagittal plane. Flex combines with IR, extension combines with ER.

Question 7

Articular surfaces of FIBULA in superior tib-fib joint (location, direction, surface description)

Answer 7

Location: fibula head

Direction: medial, anterior, superior

Description: circular and planar (styloid process is posterior-lateral)

Question 8

Describe IR/ER of the tibiofemoral joint osteokinematics

Answer 8

Impure spin in the transverse plane about a vertical axis.

Question 8

Describe the joint capsule of the superior tib-fib joint (3)

Answer 8

1. Hyaline cartilage
2. Attaches to rims of fibular facets
3. Reinforced by the anterior and posterior superior tib-fib ligaments

Question 9

Name some of the knee flexor muscles

Answer 9

Semitendinosus, semimembranosus, gracilis, plantaris, gastocnemius, popliteus, TLF

Question 9

Describe the neurology of the superior tib-fib joint

semental, contributions

Answer 9

Segmental - L4-S3

Contributions

• Common peroneal (passes over neck of fibula)
• Nerve to popliteus

Question 10

What is the primary nerve innervating the knee flexors

Answer 10

Sciatic nerve

Question 10

Vascular supply of superior tib-fib joint

Answer 10

Anterior tibial artery

ant/post tibial recurrent rami

Question 11

Name some of the knee extensors

Answer 11

Rectus femoris, vastus lateralis, vastus intermedius, vastus medialis

Question 11

Muscles attaching to the superior tib-fib joint (proximal, mid-shaft)

Answer 11

Proximal

• Biceps fem
• Peroneus longus
• Soleus
• EDL
• Tib post

Mid-shaft

• Peroneus brevis
• EHL
• FHL

Question 12

What is the primary nerve innervating the knee extensors

Answer 12

Femoral nerve

Question 12

Articular surface of the patella (type of bone, shape, pole)

Answer 12

Type of bone: Largest sesamoid

Shape:

• triangular (distally); curved (proximally)
• posterior articular surface is oval and smooth in proximal 2/3 - 3/4

Poles

• superior pole/base (proximal)
• inferior pole/apex (distal)

Question 13

Name some of the knee bursae

Answer 13

Suprapatellar bursa, pes anserin bursa, deep infrapatellar bursa, superficial infrapatellar bursa

Question 13

Describe the area between the apex and articular surface

Answer 13

Roughened | Attaches to infrapatellar fat pad

Question 14

What is the articular surface for the patella

Answer 14

Trochlea groove

Question 14

Describe the shape of the intercondylar notch

Answer 14

Shape - concave medial-lateral - convex superior-inferior (sagittal plane)

Question 16

Patellofemoral joint capsule

Answer 16

Capsule extends from the medial and lateral tibial/femoral condyles and blends with vastus lateralis/medialis. Attaches to patella and patella tendon

Question 17

Patella tendon (origin/insertion, dimensions)

Answer 17

Inferior pole to tibial tuberosity 5-6cm long, 3cm wide

Question 18

Where is the infrapatellar fat pad and what is it attached to?

Answer 18

Posterior to the patella tendon Attached to the menisci and patella

Question 19

Nerve supply to patellofemoral joint (articular, cutaneous)

Answer 19

Articular (as for tib-fem joint) - L2-S3 - Obturator - Femoral - Tibial - Common peroneal Cutaneous - Saphenous - Obturator - Lateral retinacular - medial/lateral femoral cutaneous

Question 20

Patellofemoral joint classification

Answer 20

Synovial Compound Modified sellar (operates functionally as triplanar arc or TRACKING during knee flex/extn)

Question 21

Patellofemoral joint degrees of motion

Answer 21

1 DOM

Question 22

Osteokinematics of patellofemoral joint

Answer 22

Knee flex - inferior glide Knee extn - superior glide - sagittal planes Variable tracking (tilting - transverse/sagittal planes; rotating - frontal plane)

Question 23

Arthrokinematics of patellofemoral joint (basic)

Answer 23

Inferior movement - inferior glide | Superior movement - superior glide

Question 28

Describe the articular cartilage in the patellofemoral joint

Answer 28

Cartilage - thickest in body - surface is not a mirror image of underlying bone - more permeable and pliable than other cartilage