Accessibility Tools

Knee

Total Knee Replacements:

Total knee replacements have helped millions of patients worldwide and are very successful. However, total knee surgery can be a little trickier than hip surgery for some patients. The early recovery after knee surgery is sometimes longer and tougher compared to hip replacement surgery. More physical therapy is required. The long term result for total knee replacements is outstanding. Most patients are very happy with their total knee.

Partial Knee Replacements:

Some patients need replacement of only one third of their knee which results in a more “natural” feeling knee since two thirds of the knee is left untouched. This operation is called a partial knee replacement or unicondylar knee replacement, usually on the medial (inner) side of the knee. Partial knee replacements have been shown to last as long as total knee replacements.

Knee Anatomy

The knee is a complex joint made up of different structures - bones, tendons, ligaments, and muscles. They all work together to maintain the knee’s normal function and provide stability to the knee during movement.

Having a well-functioning healthy knee is essential for our mobility and ability to participate in various activities. Understanding the anatomy of the knee enhances your ability to discuss and choose the right treatment procedure for knee problems with your doctor.

Bones of the Knee

The knee is a hinge joint made up of two bones, the thighbone (femur) and shinbone (tibia). There are two round knobs at the end of the femur called femoral condyles that articulate with the flat surface of the tibia called the tibial plateau. The tibial plateau on the inside of the leg is called the medial tibial plateau and on the outside of the leg, the lateral tibial plateau.

The two femoral condyles form a groove on the front (anterior) side of the knee called the patellofemoral groove. A small bone called the patella sits in this groove and forms the kneecap. It acts as a shield and protects the knee joint from direct trauma.

A fourth bone called the fibula is the other bone of the lower leg. This forms a small joint with the tibia. This joint has very little movement and is not considered a part of the main joint of the knee.

Articular Cartilage and Menisci of the Knee

Movement of the bones causes friction between the articulating surfaces. To reduce this friction, all articulating surfaces involved in the movement are covered with a white, shiny, slippery layer called articular cartilage. The articulating surface of the femoral condyles, tibial plateaus and the back of the patella are covered with this cartilage. The cartilage provides a smooth surface that facilitates easy movement.

To further reduce friction between the articulating surfaces of the bones, the knee joint is lined by a synovial membrane that produces a thick clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule.

Within the knee joint, between the femur and tibia, are two C-shaped cartilaginous structures called menisci. Menisci function to provide stability to the knee by spreading the weight of the upper body across the whole surface of the tibial plateau. The menisci help in load-bearing i.e. it prevents the weight from concentrating onto a small area, which could damage the articular cartilage. The menisci also act as a cushion between the femur and tibia by absorbing the shock produced by activities such as walking, running and jumping.

Ligaments of the Knee

Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral and cruciate ligaments.

Collateral ligaments are present on either side of the knee. They prevent the knee from moving too far during side to side motion. The collateral ligament on the inside is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL).

Cruciate ligaments, present inside the knee joint, control the back-and-forth motion of the knee. The cruciate ligament in the front of the knee is called anterior cruciate ligament (ACL) and the cruciate ligament in the back of the knee is called posterior cruciate ligament (PCL).

Muscles of the Knee

There are two major muscles in the knee - the quadriceps and the hamstrings, which enable movement of the knee joint. The quadriceps muscles are located in front of the thigh. When the quadriceps muscles contract, the knee straightens. The hamstrings are located at the back of the thigh. When the hamstring muscles contract, the knee bends.

Tendons of the Knee

A tendon is a tissue that attaches a muscle to a bone. The quadriceps muscles of the knee meet just above the patella and attach to it through a tendon called the quadriceps tendon. The patella further attaches to the tibia through a tendon called the patella tendon. The quadriceps muscle, quadriceps tendon, and patellar tendon all work together to straighten the knee. Similarly, the hamstring muscles at the back of the leg are attached to the knee joint with the hamstring tendon.

Knee Arthritis

Knee Arthritis

The joint surface is covered by a smooth articular surface that allows pain-free movement in the joint. Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out.

Knee Fractures

Knee Fractures

The tibia or shin bone is a major bone of the leg which connects the knee to the ankle. A tibial fracture is a break in the continuity of the shin bone (tibia).

Knee Instability

Knee Instability

Any damage to the supporting ligaments may cause the patella to slip out of the groove either partially (subluxation) or completely (dislocation).

Total Knee Replacement

Total Knee Replacement

A Total Knee Replacement (TKR) or Total Knee Arthroplasty is a surgery that replaces an arthritic knee joint with artificial metal or plastic replacement parts called the ‘prostheses’.

Partial Knee Replacement

Partial Knee Replacement

Partial knee replacement simply means that only a part of the knee joint is replaced through a smaller incision than would normally be used for a total knee replacement.

Revision Knee Replacement

Revision Knee Replacement

Unicondylar Knee Replacement simply means that only a part of the knee joint is replaced through a smaller incision than would normally be used for a total knee replacement.

Knee Arthroscopy

Knee Arthroscopy

The arthroscope is a fiber-optic telescope that can be inserted into a joint (commonly the knee, shoulder and ankle) to evaluate and treat a number of conditions.

Viscosupplementation

Viscosupplementation

Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication.

  • AAOS
  • AAHKS
  • NCOA
  • PractEssentials