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knee biomechanics
1.
2.
The knee is a mechanism of three joints and
Four bones - the femur, tibia, patella and
fibula
Interact in separate joints - the tibiofemoral &
patellofemoral
The function of these joints is to allow certain
movements, restrict others, and to provide
load transfer through the lower limb.
4.
Rotations
› Flexion/extension-0 to
1350
› varus valgus - 6-8o in
extension
› Int/ext rotation - 25 – 300
in flexion
Translations
› AP 5 - 10mm
› comp/dist 2 - 5mm
› medio-lateral 1-2mm
5.
6.
flexion axis varies in a helical fashion in a normal
knee, with an average of 2 mm of posterior
translation of the medial femoral condyle on the tibia
during flexion compared with 21 mm of translation
of the lateral femoral condyle.
Relevance :posterior rollback
› as the knee flexes, the instant center of rotation on
the femur moves posteriorly
9.
the external rotation of the tibia on
the femur during extension and
internal rotation of the tibia during
knee flexion.
cause
› medial tibial plateau articular
surface is longer than lateral
tibial plateau(Medially based
pivoting of the knee.)
relevance
› "locks" knee decreasing the
work performed by the
quadriceps while standing
10.
mechanical axis of the lower limb is defined as the
line drawn on a standing long leg antero posterior
radiograph from the center of the femoral head to
the center of the talar dome
anatomical axes of the femur and the tibia form a
valgus angle of 6 2 degrees.
the tibial articular surface is in approximately 3 0of
varus with respect to the mechanical axis, and the
femoral articular surface is in 90 of valgus.
11.
12. "sliding" articulation
› patella moves 7cm caudally
during full flexion
maximum contact between
femur and patella is at 45
degrees of flexion
The primary function of the
patella is to increase the lever
arm of the extensor mechanism
around the knee, improving
the efficiency of quadriceps
contraction.
13.
The quadriceps and patellar tendons insert anteriorly
on the patella, with the thickness of the patella
displacing their respective force vectors away from the
center of rotation of the knee .
This displacement or lengthening of the extensor lever
arm changes throughout the arc of knee motion.
the extensor lever arm is greatest at 20 degrees of
flexion, and the quadriceps force required for knee
extension increases significantly in the last 20 degrees
of extension
14.
The length of the lever arm varies as a function
of the geometry of the trochlea, the varying
patellofemoral contact areas, and the varying
center of rotation of the knee.
15. passive restraints to lateral
subluxation
› medial patellofemoral
ligament
primary passive restraint to
lateral translation in 20
degrees of flexion
60% of total restraining force
› medial patellomeniscal
ligament
13% of total restraining force
› lateral retinaculum
10% of total restraining force
dynamic restraint
› quadriceps muscles
16.
The angle between the extended
anatomical axis of the femur &
the line between the center of the
patella & the tibial tubercle
normal Q angle
› in flexion
males
13 degrees
females
18 degrees
› in extension
8 degrees
17.
Limbs with larger Q angles have a greater tendency
for lateral patellar subluxation.
Because the patella does not contact the trochlea in
early flexion, lateral subluxation of the patella in
this range is resisted primarily by the vastus
medialis obliquus fibers.
18. Position
Standing on both feet Swing phase
u/l stance phase
–
Jogging
–
force acting on joint
equal to body wt
1/2 x b.wt
2-4 x b.wt
6x b.wt
19.
Walking
› 0.3 x body weight
Ascending Stairs
› 2.5 x body weight
Descending Stairs
› 3.5 x body weight
Squatting
› 7 x body weight
20. Prevent anterior tibial displacement on femur
Secondarily, prevents hyperextension, varus &
valgus stresses
Least stress on ACL between 30-60 degrees of
flexion
Anteromedial bundle tight
in flexion & extension
Posterior lateral bundle
tight only in extension
21. Primary stabilizer of the knee against posterior
movement of the tibia on the femur
resists rotation, esp.internal rotation of tibia on
femur
Two bundles
Anterolateral, taut in flexion
Posteromedial, taut in extension