Biomechanics of Knee
Biomechanics of Knee
Biomechanics of Knee
KNEE
INTRODUCTION
• In Bilateral stance, the weight bearing stresses on the knee joint are
equally distributed between Medial and Lateral Compartment
• However, once the unilateral stance is adopted the line of force shifts
medially to the knee joint center.
• Each of these motions occur about changing but a well defined axis
FLEXION-EXTENSION
• At 90 degree, the axial rotation available is appx. 35 degree with range of lateral
rotation being 0-20 degree and medial rotation being 0-15 degree
LOCKING OR SCREW-HOME MECHANISM
OF KNEE
• There is an obligatory lateral rotation of tibia that accompanies the final stage of
knee extension that is not voluntary or produced by muscular forces
During the last 30 degree of knee extension, the shorter lateral tibial
plateau/femoral condyle pair completes its rolling-gliding motion before the longer
medial articular surfaces do
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As extension continues, the longer medial condyle continues to roll and glide
anteriorly after the lateral side of plateau is halted
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LOCKING OR SCREW-HOME MECHANISM
OF KNEE
This continued anterior motion of the medial tibia condyle results in lateral rotation
of tibia on femur, with motion most evident in the final 5 degree of extension
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The tibial tubercles are now lodged in the intercondylar notch, the menisci are
tightly imposed between tibia and femoral condyles and the ligaments are taut
bringing the knee into its closed pack or taut position
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To initiate knee flexion from full extension, the knee must first be unlocked; i.e.
laterally rotated tibia must first medially rotate concomitantly as the flexion is
initiated
PATELLOFEMORAL JOINT
ARTICULATING SURFACE OF FEMORAL SULCUS
PATELLO-FEMORAL ARTICULAR SURFACE AND JOINT
CONGRUENCE
FUNCTIONS OF PATELLA
• Enhances the leverage that the quadriceps tendon can exert on the femur,
therefore increasing the efficacy of the muscle
• The quadriceps acts primarily in line with the anatomic axis of the
femur, with the exception of the vastus medialis obliquus, which acts
to medialize the patella in terminal extension.
• Limbs with larger Q angles have a greater tendency for lateral patellar
subluxation.
INCREASED Q ANGLE
• Genu valgum
• Increased femoral anteversion.
• External tibial torsion.
• Laterally positioned tibial tuberosity.
• Tight lateral retinaculum
Pre operative radiological evalution
TEMPLATING TKA