Ligament Of Knee

INTRODUCTION:
  • The ligaments surrounding the knee joint offer stability by limiting movements and, together with the menisci and several bursae, protect the articular capsule.
INTRACAPSULAR LIGAMENT:
  • The knee is stabilized by a pair of cruciate ligaments.
1. The anterior cruciate ligament (ACL)
  • It stretches from the lateral condyle of femur to the anterior intercondylar area.
  • The ACL is critically important because it prevents the tibia from being pushed too far anterior relative to the femur.
  • It is often torn during twisting or bending of the knee.
  • Middle genicular artery is a branch of popliteal artery and supplies the cruciate ligaments & the synovial membrane of knee joint piercing the oblique popliteal ligament of knee
2. The posterior cruciate ligament (PCL)
  • Originates from Posterior part of intercondylar area of tibia
  • It stretches from medial condyle of femur to the posterior intercondylar area.
  • Injury to this ligament is uncommon but can occur as a direct result of forced trauma to the ligament.
  • This ligament prevents posterior displacement of the tibia relative to the femur.
  • Nerve supply of cruciate ligaments (ACL & PCL) is from posterior articular branch of tibial nerve.
3. The transverse ligament
  • It stretches from the lateral meniscus to the medial meniscus.
  • It passes in front of the menisci.
  • It is divided into several strips in 10% of cases.
  • The two menisci are attached to each other anteriorly by the ligament.
4. The posterior and anterior meniscofemoral ligaments
  • Stretch from the posterior horn of the lateral meniscus to the medial femoral condyle.
  • They pass posteriorly behind the posterior cruciate ligament.
  • The posterior meniscofemoral ligament is more commonly present (30%); both ligaments are present less often.
5. The meniscotibial ligaments (or "coronary") :stretches from inferior edges of the mensici to the periphery of the tibial plateaus.

EXTRACAPSULAR LIGAMENTS:

1. The patellar ligament
  • It connects the patella to the tuberosity of the tibia.
  • It is also occasionally called the patellar tendon because there is no definite separation between the quadriceps tendon (which surrounds the patella) and the area connecting the patella to the tibia.
  • This very strong ligament helps give the patella its mechanical leverage and also functions as a cap for the condyles of the femur.
  • Laterally and medially to the patellar ligament the lateral and medial retinacula connect fibers from the vasti lateralis and medialis muscles to the tibia.
  • Some fibers from the iliotibial tract radiate into the lateral retinaculum and the medial retinaculum receives some transverse fibers arising on the medial femoral epicondyle.
2. The medial collateral ligament (MCL a.k.a. "tibial")
  • It stretches from the medial epicondyle of the femur to the medial tibial condyle.
  • It is composed of three groups of fibers, one stretching between the two bones, and two fused with the medial meniscus.
  • The MCL is partly covered by the pes anserinus and the tendon of the semimembranosus passes under it.
  • It protects the medial side of the knee from being bent open by a stress applied to the lateral side of the knee (a valgus force).
3. The lateral collateral ligament (LCL a.k.a. "fibular")
  • It stretches from the lateral epicondyle of the femur to the head of fibula.
  • It is separate from both the joint capsule and the lateral meniscus.
  • It protects the lateral side from an inside bending force (a varus force). The anterolateral ligament (ALL) is situated in front of the LCL.
4.Lastly, there are two ligaments on the dorsal side of the knee.
  • The oblique popliteal ligament is a radiation of the tendon of the semimembranosus on the medial side, from where it is direct laterally and proximally.
  • The arcuate popliteal ligament originates on the apex of the head of the fibula to stretch proximally, crosses the tendon of the popliteus muscle, and passes into the capsule.
Exam Question
  • Middle genicular artery is a branch of popliteal artery and supplies the cruciate ligaments & the synovial membrane of knee joint
  • Posterior cruciate ligament Prevents posterior dislocation of tibia
  • Anterior cruciate ligament prevents Anterior dislocation of tibia
  • Middle genicular artery pierces the oblique popliteal ligament of knee
  • Posterior cruciate ligament Originates from Posterior part of intercondylar area of tibia
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