Joints

• Hip region• Knee region• Ankle region

sacroiliac joints

hip joint

pubic symphysis

Hip region

Hip region

hip jointHip region

Knee joint

• MenisciMedial meniscuslateral meniscus

• Ligaments Cruciate ligamentsCollateral ligaments Patellar ligamentoblique popliteal ligament

• Joint capsuleSynovial membraneFibrous membrane

Knee region

Minisci : fibrocartilaginous ‘shock absorbers’Knee region

semilunar cartilages

AttachmentsKnee region

1. The medial meniscus is more injured than the lateral meniscus, why?Knee region

Ligaments1. anterior cruciate ligament (ACL)2. posterior cruciate ligament (PCL)3. medial collateral ligament (MCL, tibial collateral

ligament)4. lateral collateral ligament (LCL , fibular collateral

ligament) 5. oblique popliteal ligament6. ligamentum patellae

Knee region

ACL: Anteromedial part of the intercondylar area of tibia to inner aspect of lateral condyle of femur.

PCL: Posterolateral part of the intercondylar area of the tibia to inner aspect of medial condyle of femur.

Cruciate ligamentsKnee region

Anterior Cruciate ligament prevents anterior displacement of the tibia in relation to femur in flexion.

Knee region

Posterior Cruciate ligament prevents posterior displacement of the tibia in relation to femur in extension.

Knee region

How to test ACL and PCL? Drawer sign testKnee region

15

Anterior Drawer Test for ACL

• Physician Position & Movements• Patient Position

Note direction of forces

Knee region

16

Posterior Drawer Testing- PCL

Note direction of forces

Knee region

Collateral ligaments Knee region

MCL attaches to the medial meniscus

2. The medial meniscus is more injured than the lateral meniscus, why?

Knee region

Collateral ligaments action

1. Protect the knee joint from bending side to side. 2. Helps the locking mechanism

Knee region

3. The medial meniscus is more injured than the lateral meniscus, why?

Knee region

Locking mechanism:less energy to maintain the standing

position

1. Medial rotation of femur on the tibia during full extension tighten colateral ligaments.

Knee region

Locking mechanism (2)

• Joint surfaces become larger and more stable in extension.

Knee region

Locking mechanism (3)

• body's center of gravity is positioned along a vertical line that passes anterior to the knee joint.

Knee region

Collateral ligaments testKnee region

26

Test for MCL

Note Direction Of Forces

Knee region

27

Test for LCL

Note direction of forces

Knee region

Patellar ligament

Strengthening Anterior Aspect of Knee Joint

Knee region

oblique popliteal ligamentKnee region

Review

• (1) patellar ligament • (2) tibial (medial)

collateral ligament• (3) fibular (lateral )

collateral ligament• (4) medial meniscus • (5) lateral meniscus• (6) anterior cruciate

ligament • (7) posterior cruciate

ligament

Knee region

Joint fibrous capsuleKnee region

Joint synovial membraneKnee region

Knee region

Bursa

• little fluid sacs that helps the muscles and tendons slide freely:

PrepatellarInfrapatellarSuprapatellar

Knee region

BursaKnee region

Prepatellar BursitisKnee region

Ankle region

• Ankle joint (talocrural joint)• Subtalar joint (ST J.)• Talocalcaneonavicular joint (TCN J.)

The ankle, or talocrural joint

• Needs ligaments!

Lateral ligament s of talocrural joint

Medial ligament s of talocrural joint

The ankle, or talocrural joint, is a hinge joint

• Plantar Flexion• Dorsi Flexion

Inversion/Eversion?

Intertarsal joint:

• Subtalar joint (ST J.)• Talocalcaneonavicular joint (TCN J.)• Calcaneocuboid (small rotation)• Naviculoconeiforms (almost no movement)

Calcaneous bone

Calcaneous bone

Subtalar joint

Lateral

Medial

sustentaculum tali (talar shelf) fracture

Subtalar joint

TCN joint

Talocalcaneonavicular joint

Calcaneonavicular L.

Other ligaments

• Calcaneofibular• Deltoid• Talocalcaneal

Calcaneofibular

Talar tilt test to evaluate the calcaneofibular ligament.

Deltoid

Deltoid

eversion injuries :Pott's fracture

inversion injuries: ankle sprain

Inteosseeous talocalcaneal ligament separates the ST J. from TCN J.