1. KNEE
ANKLE

2. KNEE JOINT

3. ARTICULATION
Between the condyles of the femur and the condyles of the tibia.
Anteriorly, an articulation between the lower end of the femur and the patella.
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4. TYPE Between the femur & the tibia it is a
Synovial modified hinge joint, with some degree of rotatory movement.
The joint between the femur and patella is a synovial plane gliding joint.
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5. CAPSULE
Attached to the margins of the articular surfaces and surrounds the sides and the posterior aspect of the joint.
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6. The capsule is absent anteriorlly.
It is replaced anteriorly by the quadriceps tendon, patella & Ligamentum patellae.
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7. The capsule is strengthened on each side of the patella by expansions of the tendons of vastus lateralis and medialis and posteriorly by the expansion of the semimemranous muscle (oblique popliteal ligament).
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8. SYNOVIAL MEMBRANE Attached to the margins of the articular surfaces.
Lines the interior of the capsule.
Forms several bursae around the joint.
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9. EXTRACAPSULAR LIGAMENTS
Ligamentum patellae: between the lower border of the patella & the tuberosity of the tibia. It is a continuation of the tendon of quadriceps femoris.
Lateral collateral ligament: between the lateral condyle of femur and the head of the fibula.
Medial collateral ligament: between the medial condyle of the femur and medial side of the shaft of the tibia (behind SGS). Firmly attached to the edge of the medial meniscus.
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10. Oblique popliteal ligament: strengthens the posterior side of the capsule.
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11. Anterior cruciate ligament:
INTRACAPSULAR LIGAMENTS
CRUCIATE LIGAMENTS
Anterior cruciate ligament:
Between the anterior intercondylar area of the tibia and the posterior part of the medial surface of the lateral femoral condyle.
Function: prevents posterior displacement of the femur on the tibia.
In flexed knee, prevents the tibia from being pulled anteriorly.
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12. Posterior cruciate ligament:
Between the posterior intercondylar area of the tibia and the anterior part of the lateral surface of the medial femoral condyle.
Function: prevents anterior displacement of the femur on the tibia.
In flexed knee, prevents the tibia from being pulled posteriorly.
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13. MENISCI
C-shaped intracapsular ligaments.
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14. The peripheral border is thick and attached to the capsule, the inner border is thin and free.
Each meniscus is attached to the upper surface of the tibia by anterior and posterior horns.
The medial meniscus is firmly attached to the medial collateral ligament.
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15. Function: to deepen the articular surface of the tibial condyles and to serve as shock absorber.
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16. 3- Superficial infrapatellar:
BURSAE
ANTERIOR
1- Suprapatellar:
beneath the quadriceps femoris.
2- Prepatellar:
between the skin and the patella.
3- Superficial infrapatellar:
beween the skin and the lower part of ligamentum patellae.
4- Deep infrapatellar:
between ligamentum patellae and the tibia.
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17. POSTERIOR 1- Popliteal: beneath the tendon of popliteus muscle
2- Semimembranous:
under the tendon of semimembranous muscle
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18. MOVEMENTS
Flexion:
biceps femoris, semitendinosus and semimembranosus, assisted by gracilis, sartorius and popliteus. Limited by contact with the back of thigh.
Extension:
quadriceps femoris. Limited by tension of the joint ligaments.
Medial rotation:
sartorius, gracilis and semitendinosus.
Lateral rotation:
biceps femoris.
Stability of the joint:
dependent on the tone of the muscles and the strength of the ligaments.
Prof. Makarem

19. It is necessary to start flexion.
Locked position:
in full extension, the femur is medially rotated, producing tightening of all of the ligaments and compression of the menisci.
Unlocking:
by contraction of the popliteus muscle, producing lateral rotation of the femur.
It is necessary to start flexion.
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20. INJURIES Common injury: when the knee is twisted while running
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21. ARTHROSCOPY
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22. BURSITIS
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23. ANKLE JOINT

24. ARTICULATION
Between the distal end of the tibia, the two malleoli and the body of the talus.
Type: synovial hinge joint.
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25. Medial (deltoid) ligament:
LIGAMENTS
Medial (deltoid) ligament:
from the tip of the medial malleolus to: 1- talus,
2- plantar
calcaneonavicular ligament and
3- tuberosity of the navicular bone.
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26. anterior talofibular ligament:
Lateral ligament:
3 bands
anterior talofibular ligament:
from the lateral malleolus to the lateral surface of the talus.
calcaneofibular ligament:
from the lateral malleolus to the lateral surface of the calcaneum.
posterior talofibular ligament:
from the lateral malleolus to the posterior tubercle of the talus.
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27. MOVEMENTS Dorsiflexion: Tibialis anterior, Extensor hallucis longus,
3. Extensor digitorum longus and
Peroneus tertius.
Plantar flexion:
Gastrocnemius,
Soleus,
Plantaris,
Peroneus longus,
Peroneus brevis,
Tibialis posterior,
Flexor digitorum longus and
Flexor hallucis longus.
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28. MEDICAL IMAGING
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29. INJURIES Sprained ankle: Usually inversion injury.
Severe sprains lead to torn lateral ligament and fracture of the lateral malleolus and result in instability of the ankle joint.
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