Document Title: Schulz-EKLR-Ch01-2000.shtml
Article Title: Anatomy
Author: David A. Schulz, PT, CSCS
Publication: Knee Ligament Rehabilitation, edited by Todd S. Ellenbecker. Philadelphia, Pennsylvania: Churchill Livingstone (Harcourt), 2000. (This book has 51 contributing authors and 465 pages.)
Pages: 1-15
Keywords: Knee biomechanics, ligament interdependency, ACL, PCL, MCL, LCL, tensile structures, knee motion governance.

(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables. Although this article has been published as a book chapter, it can be read independently of the other chapters in the book. Other chapters from this book can be found here.)

Comments: David Schulz, a seasoned physiotherapist, delves into the structural anatomy of the knee. The knee is able to move in 6 degrees of freedom, as defined by bearing-surface shape, but note that from the viewpoint of overall movement, flexion-extension rotation is the most important. The complex movement of the knee, most notably the combination roll-and-glide in the sagittal plane, is governed by the cruciate ligaments. This article provides important insight into how the knee ligaments work, and by implication into the types of injuries that can be expected given certain modes of forcing. (For definitions of anatomical-orientation terms such as frontal/coronal, sagittal, transverse, distal, proximal, medial and lateral, please see this document.)

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Introduction

The knee joint, or tibiofemoral joint, is the largest joint in the body. It is ginglymoid, or modified hinged, in nature, providing a large degree of range of motion.1 The knee joint itself is able to move in six degrees of freedom: the translations (anterior-posterior, medial-lateral, and proximal distal), and three rotations (internal-external, varus-valgus, and flexion-extension).2 There is little inherent knee stability because the joint is located at the ends of two long lever arms, the femur and tibia; therefore, the joint greatly depends on muscular and ligamentous structures for stability and strength.3 Secondary to this lack of osseous stability, soft tissue structures are required to withstand vast external forces, often resulting in tissue overload and injury. Consequently, knee injuries are common in the medial realm.4 To adequately diagnose and treat knee injuries, a comprehensive understanding of general anatomy is essential. In this chapter, the osseous and cartilagenous components of the knee are discussed as well as the dynamic and static soft tissue stabilizers of the joint.

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