Download Peggers` Super Summaries: Knee Anatomy

Peggers’ Super Summaries: Knee Anatomy
Knee Anatomy:
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ACL bundles
o Anteromedial – tight in flexion
o Posterolateral – tight in extension
PCL bundles
o Anterolateral – tight in flexion
o Posteromedial – tightens in extension
Muscle inserting into medial meniscus – semimembranosus
Popliteal muscle is lateral to the knee
Lateral meniscus is more circular
Medial nerve of knee – infra-patella branch of saphenous nerve sacrificed in knee surgery
leaving lateral numbness
knee
o Laterally – popliteal groove and epicondyle
o Medially – adductor tubercle and MCL/epicondyle
Wrisberg ligament
o Posterior menisco femoral ligament
o Both run from posterior horn of lateral meniscus to lateral side of medial femoral
condyle
Humphrey ligament
o Anterior meniscofemoral ligament
PCL anatomy:
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38 x 13mm in size
Humphrey & Wisberg
Which bundle taught in flexion – anterolateral
17% injured in sport the rest in RTC etc
Posterior translation increases with severity of ligamentous injury
o PCL alone – 10-12mm
o PCL + PLC - >12mm (60% involve pLC)
Instability tests
o Dial at 30 and 90o
o recurvatum
o sag sign
Lateral side layers
o Layer 1 – ITB & biceps tendon
o 2 – Retinaculum and patellofemoral ligaments
o 3 – LCL and joint capsule
How to find common peroneal nerve – posterior to LH of biceps femoris
Peggers’ Super Summaries: Knee Anatomy
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Blood supply to the knee
o Geniculate (superior/middle/inferior)
o Descending geniculate
o Recurrent anterior tibial
85% of sports related PCL injuries are good without surgery whist this figure in RTC is
only 17% ie more damage more likely NOT to cope.
Grading posterior translation
o 1 – 0-5mm
o 2 – 5-10mm
o 3 - >10mm thus needs reconstruction
Knee Menisci Quiz:
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Menisci insert into tibia via insertional ligaments
Menisci held together by intermeniscal ligament
Menisci means crescent in Greek
Ligament of wrisberg – the posterior meniscofemoral ligment ( the anterior
meniscofemroal ligament is the ligament of Humphrey - 1 or other present in 70% of
knees)
Inside out meniscal repair – split ITB and Biceps tendon and retract lateral gastrocnemius
posteriorly – potential to damage SAPHENOUR NERVE MEDIALLY
Posterior meniscal repair has better success secondary to improved blood supply
Discoid meniscus – causes the snapping knee – treatment with saucerization ie partial
removal
CI to meniscal transplant
o ACL injury
o Chondromalacia
Bucket handle tear
o Vertical mattress is better