Biomechanics of Knee

BIOMECHANICS OF
KNEE
INTRODUCTION
• Knee joint is a complex type of Modified Hinge joint
• Composed of 2 distinct articulations located within a single joint

capsule –
1. Tibiofemoral Joint
2. Patellofemoral joint
TIBIOFEMORAL ALIGNMENT
• ANATOMICAL AXIS - The relationship

of long axis of femur to the long axis of
tibia
• Forms an angle of 180 - 185 degree at

medial side of knee
• Creating a slight Physiological Valgus

at the knee
• MECHANICAL AXIS - Line drawn
between the center of the
Femoral head to the center of
the Talar head
• Typically should project through

the center of the knee –
“Neutral” Mechanical axis
MECHANICAL VARUS OR VALGUS
ALGINMENT
WEIGHT BEARING FORCES
• 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.
• This medial shift increases the Compressive stresses medially and

Tensile stresses laterally
MENISCI
• The relative Tibio-Femoral incongruence is improved by addition of
medial and lateral menisci
• Fibrocartilaginous discs which are semicircular in shape
• Medial meniscus is C shaped whereas Lateral meniscus forms Four-

Fifth of a circle. Therefore, covering about 4/5TH of the articular
surface
MENISCAL ATTACHMENTS
FUNCTION OF MENISCI
• 1. Distribute stress across the

knee during weight bearing
2. Increase the contact area and
reduces the stress at the knee
joint
3. Provide shock absorption and
Facilitate joint gliding
4. Serve as secondary joint
stabilizers
TIBIOFEMORAL JOINT KINEMATICS
• The primary angular motion of Tibiofemoral Joint is Flexion and

Extension although Internal and External rotation and Valgus/Varus
motions occur to a smaller extent
• Each of these motions occur about changing but a well defined axis
FLEXION-EXTENSION
• If the large convex femoral condyles

were permitted to roll posteriorly on
the flat tibial plateau the femur would
run out of tibia.
• This will cause femoral rolling of the

tibia and would limit flexion
MEDIAL-LATERAL ROTATION
MEDIAL-LATERAL ROTATION
• The maximum range of axial rotation is available at 90 degree of knee flexion
• The magnitude of axial rotation diminishes as knee approaches both full

extension and full flexion
• 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
|
As extension continues, the longer medial condyle continues to roll and glide
anteriorly after the lateral side of plateau is halted
|
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
|
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
|
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
• Transmits tensile force generated by the quadriceps on the patellar tendon
• Enhances the leverage that the quadriceps tendon can exert on the femur,
therefore increasing the efficacy of the muscle
• Protects anterior aspect of knee from physical trauma

PATELLOFEMORAL STABILITY
• Patellofemoral stability is maintained
by a combination of the articular
surface geometry and soft-tissue
restraints.
• The Q angle is the angle between the

extended anatomic axis of the femur
and the line between the center of
the patella and the tibial tubercle.
• Males : 8-10
• Females : 15+/- 5
PATELLOFEMORAL STABILITY
• 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

Biomechanics of Knee

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BIOMECHANICS OF

• Knee joint is a complex type of Modified Hinge joint

• Composed of 2 distinct articulations located within a single joint

• ANATOMICAL AXIS - The relationship

• Forms an angle of 180 - 185 degree at

• Creating a slight Physiological Valgus

• Typically should project through

• This medial shift increases the Compressive stresses medially and

• Fibrocartilaginous discs which are semicircular in shape

• Medial meniscus is C shaped whereas Lateral meniscus forms Four-

• 1. Distribute stress across the

• The primary angular motion of Tibiofemoral Joint is Flexion and

• If the large convex femoral condyles

• This will cause femoral rolling of the

• The magnitude of axial rotation diminishes as knee approaches both full

• Transmits tensile force generated by the quadriceps on the patellar tendon

• Protects anterior aspect of knee from physical trauma

• The Q angle is the angle between the

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