Knee Anatomy

Hip Quiz

1. Which muscle has orign at posterior sacrum and illium and inserts just distal to the greater trochanter?

2. The gluteus medius is a prime mover in this hip motion?

3. Which one joint muscle extends the hip?

4. The bony landmark of the femur located medially and posterior on the proximal end, it is illiopsoas attachment.

5. What muscles laterally rotate the hip?

Knee Joint

Knee Joint

One of the most frequently injured joints in the body.

Largest joint in the body and a synovial hinge joint.

It mainly flexes and extends, but it does have a rotational component as well.

Knee Joint

Patellofemoral joint- articulation between the patella and the femur. Patella’s main job is to increase the

mechanical advantage of the quad muscle and protect the knee joint.

Knee Joint

With a longer moment arm, there is more angular force. With a shorter moment arm, the force would be more directed to the joint than the tendon.

Knee Joint

Q-angle- angle between the quadriceps muscle and patellar tendon. It ranges from 13-18 degrees in normal individual in knee extension. It is greater in females. Due to our wider pelvis.

Lets graph our q-angles.

Knee Joint-Landmarks

Intercondylar eminence- double pointed prominence on the proximal surface of the tibial plateau.


Medial and Lateral Condyle of the tibia- proximal end of the bone just below the tibial plateau.


Tibial Plateau- proximal end including the medial and lateral condoyles and interdcondylar eminance. The top of the tibia.


Tibial Tuberosity- large projection at the proximal end and anterior side, where the patellar tendon attaches.


Patella- triangular shaped seasmoid bone within the quadriceps tendon.

Knee Joint Structures

Cruciate Ligaments- within the joint capsule, they cross. They are intracapsular ligaments and named for their attachment on the tibia.

Knee Ligaments

Anterior Cruciate Ligament- It attaches to the anterior side of the tibia just medial to the medial meniscus. It attaches to the posterior side of the femur. It prevents anterior translation of the tibia on the femur.

Knee Ligaments

Posterior Cruciate Ligament- attaches to the posterior side of the tibia. It attaches to the anterior femur and prevents posterior translation of the tibia on the femur.

Knee Ligaments

Medial Collateral Ligament- Attached to the tibia and femur on the medial side of the knee joint. Also attached to the medial meniscus, so injury to one can result in injury to both.

Knee Ligaments

Lateral Collateral Ligament- attached from the femur to the fibula on the lateral side of the knee. Shorter and stronger than the MCL.


Meniscus- medial and lateral meniscus are two half moon, wedge shaped fibrocartilage located on the superior tibia. They provide shock absorption in the knee. Medial is more often torn.


Bursa- fluid filled sac that reduce friction in a joint. The knee has 13 due to all the tendons and their vertical line of pull against bony area.

Knee Structures

Popliteal space- area behind the knee that contains important nerves and blood vessels.

The hamstrings and gastronemius make up the diamond shaped boarder.

Knee Structures

Pes Anserine muscle group- made up of Sartorius, Gracilis and semiTendinosus. (SGT). They come from posterior to medial anterior knee, there is a bursa under the insertion.

Quiz #3

1. Name the three muscles that attach at the medial anterior knee. They are know as the Pes Anserine group and their abbreviation is SGT.

2. What does ACL stand for?

3. What is the shock absorber of the knee?

Medial Collateral Ligament Sprain

Causes are blow to the

lateral knee or high speed

twisting motion. Classified with three grade

scale based on signs

and symptoms MOI is important

Medial Collateral Ligament Sprain

Signs and Sx Limited ROM Tenderness at either

insertion of MCL or along ligament length.

Various levels of pain and laxity to medial knee

Special Test

Valgus Stress Test

Treatment RICE and protect Ice and Interferential Straight leg

strengthening initially. Immobilize if

necessary

Lateral Collateral Ligament Sprain

Not as common as the MCL sprain.

Caused by a medial force to the knee joint or a twisting.

Classified with 3 grades like any other sprain.

Torn Anterior Cruciate Ligament

Can be a contact or non-contact injuy. Can be a blow to the lateral or posterior knee. Non-contact loaded

knee in combined

flexion, valgus

and rotation of the

tibia on the femur.


Signs and Sx Hear or feel a pop Rapid effusion Buckling of the knee Guarding will occur

quickly so special tests need to be done within 5 minutes of injury

Treatment Splinting, ice,

compressive wrap and crutches.

Surgery for a ACL tear in necessary

Not typically seen with grades, but they do occur

MRI is confirmation for diagnosis


Female ACL injuries happen 4-6x more often than male ACL injuries.

This is due to Biomechanical factors- use more quad than

hamstring. Land flat footed-don’t know how to jump

Hormonal influences-ligament may loosen during cycle

Anatomic risk factors-Angle of the hips relative to knees.

Knee Muscles

Popliteus- muscle responsible for unlocking the knee or initiating knee flexion. It is on the posterior side of the knee in the poplitial space deep to the gastrocnemius.

Knee Muscles

Vastus lateralis- spans the quad laterally, starts on the linea aspera and joins with the others at the patellar tendon.

Knee Muscles

Vastus Intermedialis- deep to the rectus femoris arises from the anterior surface of the femur, it blends with the other vasti muscles along its length. All extend the knee, only the rectus flexes the hip. Why?

Knee Muscles

Rectus Femoris- originates on inferior illiac spine and decends down the center of the thigh, most superficial muscle of quad.

Meniscus Tear

Meniscus are cushions in the knee joint that help make it more stable.

Medial meniscus is attached to posterior and medial side, it is more often injured.

Lateral meniscus is more freely moving, less often injured.

Meniscus Tear

Causes of injury Twisting of knee when meniscus gets trapped. When the ligaments are torn, they are attached. As people age the rubbery meniscus fray

Meniscus Tear

Signs and Sx Popping, locking,

giving way of the knee Pain in injury area General knee swelling

Osgood-Schlatter

The femur is growing faster than the quad muscle and creates a traction on the tibial tuberosity where the patellar tendon attaches.

Affects males age 12-16 Affects females age 10-14

Osgood-Schlatter

Signs and Sx Pain and swelling over tibial tuberosity Increase pain and swelling with activity Weakness of quadriceps Visible lump Pain to touch

Osgood-Schlatter

Treatment Manage pain swelling and flexibility Stretch 4x daily-emphasis on hamstrings Avoid knee extension, squats, power clean

and plyo Do body weight squats, SLR, hamstring curls

and calf raises. Wear knee brace if needed.

Patellafemoral Problems

One of the most challenging knee injuries for both athlete and health care provider.

Typical complaint is pain in front of the knee (behind the knee cap), with gradual onset.

The knee may give way and have a grinding noise.

Patellar Tendonitis

High force repetitive injury usually a result of jumping and/or abrupt change of direction.

AKA jumpers knee

Patellar Tendonitis

Signs and Sx: Anterior knee pain

inferior to patellar tendon

Small amount of swelling

Special Tests-

Tap Test

Clark’s Sign

Treatment Modified activity to

decrease impact Stretch Quads Ice after Massage/US before Brace and Tape

Knee Muscles

Vastus medialis- also comes from the linea aspera and spans the thigh medially and joints with quads at patellar tendon.

Knee Muscles

Semitendinosus muscle- longer and narrower distal tendon that moves to the anterior tibia with the grasillis and sartoris after spanning the posterior medial thigh.

Knee Muscles

Semimembranosus muscle- runs down medial side of the thigh deep to the semitendinosus muscle and attaches to the medial condyle of tibia.

Knee Muscles

Biceps Femoris- has two head and runs down the thigh laterally on the posterior side. The long head starts of the ischial tuberosity, the short head on the linea aspera. Which head flexes the knee and extends the hip?

Knee Anatomy

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