Knee

The knee is a complex joint made up of different structures including bones, tendons, ligaments and muscles. They all work together to maintain normal function and provide stability to the knee during movement.

Having a well-functioning healthy knee is essential for our mobility and ability to participate in various activities. Understanding the anatomy of the knee enhances your ability to discuss and choose the right treatment procedure for knee problems with your doctor.

Bones

The Knee is a hinge joint made up of two bones, the thigh bone (femur) and the shinbone (tibia). There are two round knobs at the end of the femur called femoral condyles which articulate with the flat surface of the tibia called the tibial plateau. The tibia plateau on the inside of the leg is called the medial tibial plateau, and on the outside of the leg it is called the lateral tibial plateau.

The two femoral condyles form a groove on the front (anterior) side of the knee called the patellofemoral groove. A small bone called the patella sits in this groove and forms the knee cap. It acts as a shield and protects the knee joint from direct trauma.

A fourth bone called the fibula is the other bone of the lower leg. This form a small joint with the tibia. This joint has very little movement and is not considered a part of the main joint of the knee.

Articular Cartilage and Menisci

Movement of the bones causes friction between the articulating surfaces. To reduce this friction, all articulating surfaces involved in movement are covered with a white, shiny, slippery layer called articular cartilage. The articulating surface of the femoral condyles, tibial plateaus and the back of the patella are covered with this cartilage. The cartilage provides a smooth surface that facilitates easy movement.

To further reduce friction between the articulating surfaces of the bones, the knee joint is lined by a synovial membrane which produces a thick clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule.

Within the knee joint between the femur and tibia there are two C shaped cartilaginous structures called menisci. Menisci function to provide stability to the knee by spreading the weight of the upper body across the whole surface of the tibial plateau.  The menisci help in load bearing by preventing the weight from concentrating onto a small area, which could damage the articular cartilage. The menisci also act as a cushion between the femur and tibia by absorbing the shock produced by activities such as walking, running and jumping.

Ligaments

 Ligaments are tough bands of tissue that connect one bone to another bone.  The ligaments of the knee function to stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral ligaments and the cruciate ligament.

Collateral ligaments are present on either side of the knee. They function to prevent the knee from moving too far during side to side motion. The collateral ligament on the inside is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL).

Cruciate ligaments- This group of ligaments, present inside the knee joint, control the back and forth motion of the knee.  The Cruciate ligament in the front of the knee is called anterior cruciate ligament or ACL and the cruciate ligament in the back of the knee is called posterior cruciate ligament or PCL.

Muscles

Muscles: There are two major muscles, the quadriceps and the hamstrings, which enable movement of the knee joint. The quadriceps muscles are in the front of the thigh. When the quadriceps muscles contract, the knee straightens. The hamstrings are in the back of the thigh. When the hamstring muscles contract, the knee bends.

Tendons

Tendons are structures that attach muscles to the bone. The quadriceps muscles of the knee meet just above the patella and attach to it through a tendon called the quadriceps tendon. The patella further attaches to the tibia through a tendon called the patella tendon. The quadriceps muscle, quadriceps tendon and patellar tendon all work together to straighten the knee. Similarly, the hamstring muscles at the back of the leg are attached to the knee joint with the hamstring tendon.

 

• Knee Pain

  

  The knee is one of the largest joints in the body, formed by the lower end of the femur, upper end of the tibia and the patella or knee cap. Several ligaments and muscles attach to the bones...

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• Anterior Knee Pain

  Anterior knee pain is a characterized by a chronic pain over the front and center of the knee joint. It is common in athletes, active adolescents (especially girls) and overweight individuals...

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• Runner’s Knee

  Runner's knee, also called patellofemoral pain syndrome refers to pain under and around your kneecap. Runner’s knee includes several medical conditions such as anterior...

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• Osgood Schlatter Disease

  Osgood-Schlatter disease refers to a condition of an overuse injury that occurs in the knee region of growing children and adolescents. This is caused by inflammation of the tendon located...

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• Chondromalacia Patella

  The patella, also called the kneecap is a small bone present on the front of your knee joint. The underside of the patella is covered by cartilage that allows smooth gliding of the knee...

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• Jumper’s Knee

  Jumper’s knee, also known as “patellar tendinitis" is an inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps...

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• Bursitis

  A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation...

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• Baker’s Cyst

  The knee consists of a fluid called synovial fluid, which reduces friction between the bones of the knee joint while you move your leg. Sometimes this fluid is produced in excess...

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• Iliotibial Band Syndrome

  Iliotibial band syndrome is an overuse injury resulting from the inflammation of iliotibial band. Iliotibial band is a tough group of fibers that begins at the iliac crest of hip and runs along...

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• Lateral Patellar Compression Syndrome

  Lateral patellar compression syndrome refers to pain under and around your kneecap. It is a common complaint among runners, jumpers, and other athletes such as skiers, cyclists, and soccer players...

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• Osteochondritis Dissecans

  Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone separates from the end of the bone because of inadequate blood supply.

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• Shin Splints

  “Shin splints” is used to describe the pain and inflammation of the tendons, muscles and bone tissue around the tibia or shine bone (a large bone in the lower leg). It occurs because

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• Knee Injury

  Pain, swelling and stiffness are the common symptoms of any damage or injury to the knee. If care is not taken during the initial phases of injury, it may lead to joint damage...

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• Unstable Knee

  The knee joint is one of the largest joints in the body. This highly complex joint has several tissues supporting and stabilizing its movement:

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• Goosefoot Bursitis of the Knee

  A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation...

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• Knee Sprain

  Knee sprain is a common injury that occurs from overstretching of the ligaments that support the knee joint. A knee sprain occurs when the knee ligaments are twisted or turned...

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• ACL Tears

  The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee that is in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone)...

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• MCL Tears

  The medial collateral ligament (MCL) is the ligament that is located on the inner part of the knee joint. It runs from the femur (thighbone) to the top of the tibia (shinbone)...

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• MCL Sprain

  The medial collateral ligament (MCL), a band of tissue present on the inside of your knee joint, connects your thigh bone and shin bone (bone of your lower leg)...

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• Meniscal Injuries

  The knee is one of the most complex and largest joint in the body, and is more susceptible to injury. Meniscal tears are one among the common injuries to the knee joint...

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• Meniscal Tears

  Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee cause the meniscus to tear...

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• Ligament Injuries

  

  The knee is a complex joint which consists of bone, cartilage, ligaments and tendons that make joint movements easy and at the same time more susceptible to various kinds of injuries...

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• Multiligament Instability

  The knee is a complex joint of the body which is vital for movement. The four major ligaments of the knee are anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament...

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• Knee Arthritis

  

  Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. The joint surface is covered by a smooth articular surface that allows pain free movement...

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• Patellar Dislocation/Patellofemoral Dislocation

  

  Patella (knee cap) is a protective bone attached to the quadriceps muscles of the thigh by quadriceps tendon. Patella attaches with the femur bone and forms a patellofemoral joint...

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• PCL Injuries

  Posterior cruciate ligament (PCL), one of four major ligaments of the knee are situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia)...

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• Chondral (Articular Cartilage Defects)

  Articular or hyaline cartilage is the tissue lining the surface of the two bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight...

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• Patellar Instability

  

  Patellar (knee cap) instability results from one or more dislocations or partial dislocations (subluxations). Patella is the small piece of bone in front of the knee that slides...

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• Patellofemoral Instability

  The knee can be divided into three compartments: patellofemoral, medial and lateral compartment. The patellofemoral compartment is the compartment in the front of the knee between...

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• Patella Fracture

  The knee cap or patella is the largest sesamoid bone in the body and one of the components of the knee joint, present at the front of the knee. The undersurface of the kneecap

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• Recurrent Patella Dislocation

  The patella (knee cap) is a small bone that shields your knee joint. It is found in front of your knee, in a groove called the trochlear groove that sits at the junction of the femur (thighbone) and tibia (shinbone)...

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• Quadriceps Tendon Rupture

  Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg...

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• Patella Tendon Rupture

  Patella tendon rupture is the rupture of the tendon that connects the patella (knee cap) to the top portion of the tibia (shin bone). The patellar tendon works together with the quadriceps muscle

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• Lateral Meniscus Syndrome

  The knee joint is formed by the union of two bones, namely the femur (thigh bone) and the tibia (lower leg bone). At the junction of these two bones is a cartilage called the meniscus...

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• Medial Meniscus Syndrome

  Of the menisci within the knee, it is the medial that is more easily injured. Differences in the anatomical attachments of the medial meniscus compared to the lateral mean...

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• Tibial Eminence Spine Avulsions

  Tibial eminence spine avulsion fracture is avulsion (tear away) of the tibial eminence (an extension on the bone for attachment of muscles) which most commonly involves the anterior...

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• Osteonecrosis of the Knee

  Osteonecrosis is a condition in which death of a section of bone occurs because of lack of blood supply to it. It is one of the most common causes of knee pain in older women...

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• Knee Angular Deformities

  Angular deformities of the knee are common during childhood and usually are variations in the normal growth pattern. Angular deformity of the knee is a part of normal...

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• Pharmacological

  The knee is a complex joint which consists of bone, cartilage, ligaments and tendons that make joint movements easy and at the same time more susceptible to various kinds of injuries...

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• PRP

  Platelet rich plasma (PRP) is a treatment used to promote healing of injured joints, muscles, ligaments and tendons. It is mostly used in athletes and active individuals who wish to return to their sport or activity quickly.

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• Viscosupplementation

  Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication...

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• Cortisone Injection

  Cortisone is a corticosteroid released by the adrenal gland in response to stress and is a potent anti-inflammatory agent. Artificial preparations containing cortisone are injected directly...

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• Physiotherapy

  Physiotherapy or physical therapy is an exercise program that helps you to improve movement, relieve pain, encourage blood flow for faster healing, and restore your physical...

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• Knee Arthroscopy

  

  Knee Arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to consider the knee joint to diagnose or treat a knee problem...

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Knee Replacement and Reconstruction

• Knee Osteotomy

  Knee Osteotomy is a surgical procedure in which the upper shinbone (tibia) or lower thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only...

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• High Tibial Osteotomy

  High tibial osteotomy is a surgical procedure performed to relieve pressure on the damaged site of an arthritic knee joint. It is usually performed in arthritic conditions affecting...

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• Tibial Tubercle Osteotomy

  Tibial tubercle osteotomy is a surgical procedure which is performed along with other procedures to treat patellar instability, patellofemoral pain, and osteoarthritis...

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• Unicompartmental Knee Replacement

  Unicompartmental knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant. It is also called a partial knee replacement...

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• Patellofemoral Knee Replacement

  Patellofemoral Knee Replacement surgery may be recommended by your surgeon if you have osteoarthritis contained to the patellofemoral compartment and you have not obtained...

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• What is new in Knee Replacement

  For a patient considering knee replacement surgery, there are new developments under study which can help enhance their quality of life. These include:

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• Computer Navigation for Total Knee Replacement

  A total knee replacement surgery is the last resort to relieve pain and restore function in knee damaged by arthritis or an injury when non-surgical treatments do not relieve the condition...

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• Total Knee Replacement

  Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with artificial parts...

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• Revision Knee Replacement

  Revision knee replacement surgery involves replacing part or all your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes

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• Medial Patellofemoral Ligament Reconstruction

  Medial patellofemoral ligament reconstruction is a surgical procedure indicated in patients with more severe patellar instability. Medial patellofemoral ligament is a band...

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• Distal Realignment Procedures

  Distal realignment procedures, also known as TTT or tibial tubercle transfer procedures are performed to reposition the kneecap by realigning the tendon under the kneecap...

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• Arthroscopic Reconstruction of the Knee for Ligament Injuries

  The knee is the most complex joint in the body and is formed by the articulation between the thigh bone (femur) and the shinbone (tibia). A knee cap is present over the front of the joint...

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• PCL Reconstruction

  Posterior cruciate ligament (PCL), one of four major ligaments of the knee are situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia)...

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• LCL Reconstruction

  Lateral collateral ligament (LCL) is a thin set of tissues present on the outer side of the knee, connecting the thighbone (femur) to the fibula (side bone of lower leg)...

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• ACL Reconstruction

  

  The anterior cruciate ligament is one of the major stabilizing ligaments in the knee. It is a strong rope like structure located in the center of the knee running from the femur to the tibia...

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• Outpatient Total Knee Replacement

  Total knee replacement is the surgical treatment for knee arthritis, where the damaged knee is removed and replaced with an artificial knee implant...

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• Tricompartmental Knee Replacement

  Tricompartmental knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with artificial parts...

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• After Knee Replacement

  Knee replacement is a surgery performed to replace parts of a diseased knee joint with an artificial prosthesis. The goal of knee replacement is to eliminate pain and return...

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Cartilage Restoration

• Patellar Tendon Repair

  Patella tendon rupture is the rupture of the tendon that connects the patella (knee cap) to the top portion of the tibia (shin bone). The patellar tendon works together with the quadriceps...

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• Knee Ligament Reconstruction

  The knee is the most complex joint in the body and is formed by the articulation between the thigh bone (femur) and the shinbone (tibia). A knee cap is present over the front of the joint...

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• Cartilage Replacement

  Cartilage replacement is a surgical procedure performed to replace the worn-out cartilage with the new cartilage. It is usually performed to treat patients with small areas of cartilage...

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• Cartilage Repair and Transplantation

  Articular Cartilage is the white tissue lining the end of bones where these bones connect to form joints. Cartilage acts as cushioning material and helps in smooth gliding of bones...

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• OATS

  OATS is “osteochondral autograft transfer system”. It is one of the two types of cartilage transfer procedures and the other procedure is “Mosaicplasty”...

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Others

• Autologus Chondrocyte Implantation

  Autologous chondrocyte implantation (ACI) is a procedure to treat the articular cartilage defects of the knee. This procedure is effective for treating small areas of cartilage damage that causes...

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• Subchondroplasty

  Knee osteoarthritis (OA) is a common form of arthritis that causes joint pain and stiffness. It is a progressive disease in which the joint cartilage gradually wears away and may lead to disability...

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• Partial Meniscectomy

  Partial meniscectomy is a surgical procedure to remove the torn portion of the meniscus from the knee joint. Meniscus is the C-shaped cartilage located in the knee that lubricates...

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• Meniscal Surgery

  Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee cause the meniscus to tear...

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• Limb Lengthening

  Limb lengthening is a reconstructive procedure where the deformed bone is straightened or missing bone is replaced. It is performed in children and adults who have variations in their...

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