Massage Therapy Journal Spring 2024

36 • Massage Therapy Journal

AMTA Continuing Education

The Knee Joint: Anatomy Review The knee joint is a modified hinge joint that creates an articulation between the femur and the tibia and is the largest and most complex joint in the human body. The knee joint allows for flexion and extension movements along with medial and lateral rotation and involves the articulation of three bones: the femur, tibia and patella. The femur has two rounded condyles at its distal end that articulate with the upper surface

of the tibia. The patella, situated at the anterior aspect of the knee joint, delivers protection and can improve the mechanical advantage of the quadriceps muscle. The knee joint is surrounded by a fibrous joint capsule, which is reinforced by several ligaments that help provide support and stability. See Figure 11. The knee is capable of flexion and extension, while also allowing for medial and lateral rotation when the knee is in flexion. 2 Note the knee joint ligaments location and function in the chart below and in Figure 12 . The knee joint also contains two menisci, known as the medial and lateral menisci. They are C-shaped cartilaginous structures that lie on top of the tibial plateau. These structures help with shock absorption, load distribution and stability of the knee joint. See Figure 13. Note the movement the knee joint can perform and its range of motion in the chart below.

Figure 11, 12 and 13

Vastus medialis obliquus

Vastus lateralis

Femur

Quaddriceps tendor

Patella

Articular cartilage

Patellar ligament

Lateral meniscus

Medial meniscus

Range of Motion

Joint

Movement

Lateral collateral ligament

Medial collateral ligament

Knee joint

Extension–flexion 0-135º Medial rotation 0-25º Lateral rotation 0-45º

Fibula

Tibia

Knee Joint Ligaments Location

Function

Inside the knee joint and crosses from the anterior aspect of the tibia to the posterior aspect of the femur Inside the knee joint and crosses from the posterior part of the tibia to the anterior part of the femur Connects the medial aspect of the knee to the medial tibia Connects the lateral aspect of the knee to the fibular head Continuation of the quadriceps tendon and connects the patella to the tibial tuberosity Band of connective tissue on the lateral aspects of the patella that helps maintain its position

Prevents excessive forward movement of the tibia on the femur and contributes to rotational stability. It is also critical for preventing hyperextension of the knee Prevents excessive posterior movement of the tibia on the femur and provides stability during weight bearing activities Prevents excessive outward (valgus) movement of the knee joint and provides stability against forces pushing the knee medially Prevents excessive inward (varus) movement of the knee joint and provides stability against forces pushing the knee laterally Transmits the force generated by the quadriceps muscles to the tibia during knee extension Stabilizes the patella in alignment and prevents it from dislocating during knee movements

Anterior cruciate ligament (ACL)

Posterior cruciate ligament (PCL) Tibial (medial) collateral ligament (TCL) Fibular (lateral) collateral ligament (FCL) Patellar ligament (patellar tendon)

Patellar retinaculum

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