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Sport FRCS > Ligaments of the Knee > Flashcards

Ligaments of the Knee Flashcards

ACL PCL LCL PLC MCL Postmed corner

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1
Q

What is the function of the ACL?

A
  • Prevents anterior translation of the tibia to the femur
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2
Q

Name the origin, insertion and structure of the ACL?

A
  • Origin
    • Lateral Femoral condyle
  • Insertion
    • Broad and irregular
    • anterior between Intercondyle eminence of the tiba
  • ​Structure
    • ​33mmx11mm in size
    • 2 bundles
      • anteromedial
      • Posteriolateral
        • prevents pivot shifting of knee
        • prevents internal tibial rotation w knee near extension
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3
Q

What is the blood supply to the ACL?

A
  • Middle geniculate artery
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4
Q

What is the ACL composed of and what is it biomechanical strengths?

A
  • 90% type 1 Collagen
  • 10% type 3 Collagen

Strength

  • 2200N
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5
Q

Describe which bundles of the ACL are tight in flexion and extension?

A
  • Anteromedial ACL =Tight in Flexion
  • Posteriolateral ACL =Tight in Extension
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6
Q

What is the function of PCL?

A
  • Prevents posterior translation of tibia relative to femur
  • PCL and posterior lateral corner work to Resist Posterior translation and posterolateral rotatory instability
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7
Q

Describe the origin, insertion, and structure of the PCL?

A
  • Origin
    • Medial femoral condyle
  • Insertion
    • Tibial sulcus
  • Structure
    • 38x13mm in size
    • 2 bundles
      • anterolateral
      • posteriomedial
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8
Q

What ligaments originate from the posterior horn of the lateral meniscus and insert into the substance of the PCL?

A
  • Ligament of Humphrey - Anterior to PCL
  • Ligament of Wrisberg- Posterior to PCL
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9
Q

What is the blood supply and strength of PCL?

A
  • Middle Geniculate artery
  • strength 2500N
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10
Q

Descibe what happens to the 2 bundle of the PCL in knee flexion & extension?

A
  • Anterolateral bundle= tight in flexion
  • Posteriomedial bundle= tight in extension
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11
Q

What is the function of LCL?

A
  • provide support to varus angulation
  • works in concert with MCL to provide restraint to axial rotation
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12
Q

What is the origin, insertion, path and structure of the LCL?

A
  • origin
    • Lateral femoral condyle POSTERIOR and SUPERIOR to insertion of POPLITEUS
  • Path
    • runs Superficial to POPLITEUS
  • Insertion
    • on the fibula Anterior to popliteofemoral ligament of the fibula
    • caspule’s most distant extent is joust post to fibular
  • Structure
    • cord like
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13
Q

Describe the biomechanics and strength of the LCL?

A
  • Tight in extension
  • Lax in flexion
  • strength
    • 750N
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14
Q

What is the function of the posterolateral corner?

A
  • works synergistically with PCL to control EXTERNAL ROTATION and POSTERIOR Translation
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15
Q

What structures are involved in the posterolateral corner?

A
  • LCL (295N)
  • Popliteus muscle & tendon (680N)
  • Poplteofibular ligament ( 229N)
  • Lateral capsule

Variable

  • arcuate ligament
  • iliotibial track
  • fabellofibular ligament
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16
Q

What is the function of the MCL?

A
  • To provide restraint to valgus angulation
  • works in concert with the ACl to provide restraint to axial rotation
17
Q

What is the origin, structure and biomechanics of the MCL?

A
  • Origin
    • medial femoral condyle to medial tibia extending down several cm
  • Structure
    • 2components
    • Superificial Portion (tibial collateral lig)
      • just deep to gracilis and semitendinosis
      • inserts into periosteum of prox tibia ( deep to pes anerinus)
      • primarly stabliser to Valgus stress
      • contributes 57%, 78% of medial stability at 5 and 25 degrees of flexion
    • Deep ( medial capsular lig)
      • separated from superificial by bursa
      • attaches to medial meniscus
      • divides into menisofemoral and mensicotibial portions
      • acts as secondary restraints to valgus stress at full extension
  • ​​Biomechanical
    • 4000N
18
Q

What is the function of the posteromedial corner?

A
  • Important for rotatory stability
19
Q

Describe the anatomy of the postermedial corner?

A
  • Lies deep to MCL
  • formed by
    • semimembranosus
    • posterior oblique ligament
      • resists tibial internal rotation in full extension
    • oblique popliteal ligament
    • posterior capsule
20
Q

Describe the osseous anatomy of the patella?

A
  • Post surface has 2 cartilaginous facets
    • medial
    • lateral
    • for articulationw distal femur
21
Q

Describe the anatomy of the distal femoral condyles?

A
  • Form the intercondylar groove for articulation w patella
  • diameter of lateral femoral condyle> medial femoral condyle
22
Q

Describe the stability of the patella within the trochlear groove?

A
  • Dynamic stability
    • Vastus medialis= medial restraint to lateral translation
    • Vastus lateralis= lateral restraint to medial translation
  • Static stability
    • medial patellofemoral ligament (MPFL)
    • femoral insertion origin between medial epicondyle and adductor tubercle
    • primary restraint in 1st 20 degrees of flexion
23
Q

What is the Q angle?

A
  • angular differences between the quadriceps insertion and patella insertion create a Valgus angle
  • first line from ASIS to middle of patella
  • 2nd line form tibial tuberosity to middle of patella
  • where they intersect = Q angle
  • normal males 13 degrees, females 18 degrees
  • creates a laterally directed force across the patellofemoral joint
24
Q

What is the function of the patella?

A
  • To transmit tensile forces generated by the quadriceps to the patella tendon
  • increases the lever arm of extensor mechanism
  • A patellectomy decreases extension force by 30%
25
Q

How far does the patella move during full flexion and at what angle is there max contact between patella and femur?

A
  • 7mm
  • 45 degrees
26
Q

What is the best modality to measure articular cartilage of the knee ?

A
  • MRI
  • T2 sequence
    *

Sport FRCS (26 decks)

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