Tkrbiomechanics 131212112118 Phpapp01

 The knee is a mechanism of three joints
and Four bones - the femur, tibia, patella

and fibula
 Interact in separate joints - the

tibiofemoral & patellofemoral
 The function of these joints is to allow

certain movements, restrict others, and to
provide load transfer through the lower
limb.
 Tibiofemoral joint
rotations
translations
screw
home
mechanism
 Axial &
rotational
alignment of
knee

Rotations
› Flexion/extension-0 to
1350
› varus valgus - 6-8o in
extension
› Int/ext rotation - 25 – 300
in flexion
 Translations
› AP 5 - 10mm
› comp/dist 2 - 5mm
› medio-lateral 1-
2mm
 flexion axis varies in a helical fashion in a normal
knee, with an average of 2 mm of posterior
translation of the medial femoral condyle on the tibia
during flexion compared with 21 mm of translation
of the lateral femoral condyle.
 Relevance :posterior rollback

› as the knee flexes, the instant center of rotation on
the femur moves posteriorly
 flexion axis as varying in a helical fashion
allows for increased knee flexion by avoiding impingement
 the external rotation of the tibia
on the femur during extension
and internal rotation of the tibia
during knee flexion.
 cause
› medial tibial plateau
articular surface is longer
than lateral tibial
plateau(Medially based
pivoting of the knee.)
 relevance
› "locks" knee decreasing
the work performed by the
quadriceps while standing
 mechanical axis of the lower limb is defined as the
line drawn on a standing long leg antero posterior
radiograph from the center of the femoral head to
the center of the talar dome
 anatomical axes of the femur and the tibia form a

valgus angle of 6 2 degrees.
 the tibial articular surface is in approximately 3

0of varus with respect to the mechanical axis, and
the femoral articular surface is in 90 of valgus.

 "sliding" articulation
› patella moves 7cm
caudally during full
flexion
 maximum contact between
femur and patella is at 45
degrees of flexion
 The primary function of the

patella is to increase the lever
arm of the extensor mechanism
around the knee, improving
the efficiency of quadriceps
contraction.
 The quadriceps and patellar tendons insert anteriorly
on the patella, with the thickness of the patella
displacing their respective force vectors away from the
center of rotation of the knee .
 This displacement or lengthening of the extensor lever

arm changes throughout the arc of knee motion.
 the extensor lever arm is greatest at 20 degrees of

flexion, and the quadriceps force required for knee
extension increases significantly in the last 20 degrees
of extension
 The length of the lever arm varies as a
function of the geometry of the trochlea, the
varying patellofemoral contact areas, and the
varying center of rotation of the knee.
 passive restraints to
lateral subluxation
› medial patellofemoral
ligament
 primary passive restraint
to lateral translation in 20
degrees of flexion
 60% of total restraining
force
› medial patellomeniscal
ligament
 13% of total
restraining force
› lateral retinaculum
 10% of total
restraining force
 The angle between the
extended anatomical axis of the
femur & the line
between the center of the patella
& the tibial tubercle
 normal Q angle
› in flexion
 males
13 degrees
 females
18 degrees
› in extension
 8 degrees
 Limbs with larger Q angles have a greater tendencyfor
lateral patellar subluxation.
 Because the patella does not contact the trochlea in

early flexion, lateral subluxation of the patella in
this range is resisted primarily by the vastus
medialis obliquus fibers.
Position force acting on joint
 Standing on both feet equal to body wt
- 1/2 x b.wt
 Swing phase 2-4 x b.wt
- 6x b.wt
 u/l stance phase
–
 Jogging
–

Walking
› 0.3 x body
weight
 Ascending Stairs
› 2.5 x body
weight
 Descending Stairs
› 3.5 x body
weight
 Squatting
› 7 x body
weight
 Prevent anterior tibial displacement on femur
 Secondarily, prevents hyperextension, varus &
valgus stresses
 Least stress on ACL between 30-60 degrees of
flexion
Anteromedial bundle tight in

flexion & extension
Posterior lateral bundle

tight only in extension
 Primary stabilizer of the knee against posterior
movement of the tibia on the femur
 resists rotation, esp.internal rotation of tibia on
femur
Two bundles
 Anterolateral, taut in flexion
 Posteromedial, taut in extension

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Tkrbiomechanics 131212112118 Phpapp01

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 The knee is a mechanism of three joints

and Four bones - the femur, tibia, patella

 Interact in separate joints - the

 The function of these joints is to allow

 Relevance :posterior rollback

 anatomical axes of the femur and the tibia form a

 the tibial articular surface is in approximately 3

the femoral articular surface is in 90 of valgus.

 The primary function of the

 This displacement or lengthening of the extensor lever

 the extensor lever arm is greatest at 20 degrees of

 Because the patella does not contact the trochlea in

Anteromedial bundle tight in

Posterior lateral bundle

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