Knee anatomy

Examples of knee arthroplasty during the 1960s. (A) Walldius hinged knee replacement (B) the Shiers, Walldius, and Guepar hinged knee replacements, superimposed over the anatomy of the knee (reprinted with permission from Walker RS. 1977. Human joints and their artificial replacements. Springfield, IL CC Thomas Publisher) (C) Macintosh tibial plateau and (D) McKeever tibial plateau. 

In general, the success rate of TSR exceeds 90% for a wide range of common shoulder problems. As in THA and TKA, the aim of TSA is to reduce pain, restore damaged anatomy, and restore function. As for hip and knee arthroplasty, there are continuing concerns about component fixation and persisting instability of the joint. 

Rigid geometric registration between a surface model obtained from preoperative CT and intraoperative surface data on the same anatomy obtained by touching landmarks or collecting sample points with a tracker. This method is widely used in CIS orthopedic systems, such as pedicle screw fixation, total hip and knee replacement, and trauma. 

The anatomy of the ACL in relation to the knee joint architecture. Proximally, it is attached to the posterior aspect of the medial surface of the lateral femoral condyle, passing in front of the PCL and attaching distally on the tibial plateau. 

The traditional single-bundle reconstruction is designed to replicate the anatomy of the AM bundle (Fig. 20.9). The debate regarding the reconstruction of the two different bundles comes principally from the fact that the PL bundle is an important structure for stabilizing the knee, especially in... 

Dnthon VB, Barea C, Abrassart, Easel JH, Fritschy and Menetrey J. Anatomy of the anterior cruciate ligament. Knee Surg Sports TraumatolArthros. 2006 14 204-213. 

Zantop T, Petersen W, Sekiya JK et al (2006) Anterior cruciate ligament anatomy and function relating to anatomical reconstractirai. Knee Surg Sports Traumatol Arthrosc 14 982-992... 

Bicer EK, Lustig S, Servien E et al (2010) Current knowledge in the anatomy of the human anterior cruciate ligament Knee Surg Sports Traumatol Arthrosc 18 1075-1084... 

MRI allows for the reliable assessment of knee structure and the diagnosis ACL injuries. In this chapter, the MRI signal characteristics of the ACL were demonstrated based on the anatomy of the ACL. Depending on the mechanism of ACL injury, attention should be directed toward not only the ligament but also the characteristics of the surrounding knee structures, such as bone bruises and anterior tibial translation. Both standard orthogonal and additional oblique MRI views should be utilized to ensure accurate and reproducible image interpretation. 

Staeubli HU, Adam O, Becker W, Burgkart R (1999) Anterior cmciate ligament and intercondylar notch in the coronal oblique plane anatomy complemented by magnetic resonance imaging in cruciate ligament-intact knees. Arthroscopy 15(4) 349-359... 

Zantop T, Diermann N, Schumacher T, Schanz S, Fu FH, Petersen W (2008) Anatomieal and nonanatomical double-bundle anterior cruciate ligament reconstruction importance of femoral tunnel location on knee kinematics. Am J Sports Med 36(4) 678-685. doi 10.1177/ 0363546508314414... 

It is critical to understand functional anatomy and biomechanics of the AM and PL bundles of the ACL in order to understand the theory of the anatomic double-bimdle ACL reconstruction. It has been well known that the mid-substance fibers of the AM and PL bundles have different functions The AM bundle mid-substance is stretched in the full extension position, relaxed at 20-60 ° of knee flexion, and again stretched in a flexion position of more than 90° [9]. The PL bundle mid-substance is stretched in the full extension position, whereas it becomes slack in a flexion position [9]. In response to an anterior tibial load, the magnitude of the in situ force in the PL bundle mid-substance was larger than that in the AM bundle mid-substance at knee flexion angles between 0 ° and 45 ° [10]. Under a combined rotatory load, the PL bundle mid-substance is as important as the AM bundle mid-substance, especially when the knee is in the near extension position [11]. 

Friedrich NF, O Brien WR (1992) Functional anatomy of the cruciate ligaments. In Jakob RP, Staeubli H-U (eds) The knee and the cruciate ligaments. Springer, Berlin, pp 78-91... 

Fractures of both the femur and the tibia results in an unstable middle segment, the floating knee . These injuries are fortunately rare and typically result from road traffic accidents. One or both fractures may be open and there is often associated head or thoracic trauma. Healing is slow due to the significant soft tissue trauma and it is difficult to maintain alignment of the limb. In view of this, it is recommended that at least one of the fractures should be surgically stabilised. The advent of ESIN which can be inserted with minimal soft tissue trauma has seen a trend towards internal fixation of both fractures, providing the local anatomy allows. This approach is precluded if one or other fracture is in close proximity to the joint. The fractures have been classified by Letts and Vincent (Letts et al. 1986). 

Petersen, W., Tillmann, B., 1998. Collagenous fibril texture of the human knee joint menisci. Anatomy and Embryology 197 (4), 317—324. 

Pennock, G.R., and Clark, K.J., An anatomy-based coordinate system for the description of the kinematic displacements in the human knee.. Biomech., 23, pp. 1209-1218,1990. 

Fig. 3 Knee joint and quadriceps anatomy of the human (left) and rabbit (right) knee. Note that the arrangement of the knee extensor muscles and their insertion into the patella is similar in human and rabbit knees.

Goldblatt JP, Richmond JC (2003) Anatomy and biomechanics of the knee. Oper Techn Sport Med 11 172-186. 

A basic description of the complex anatomy of the knee with emphasis on the anatomic structures amenable to US examination, such as joint and ligamentous complexes, tendons, neurovascular structures and bursae, is included here. 

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