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The Knee
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The Knee

The knee is a ‘hinge’ joint made up of two separate joints, four bones, and a group of muscles, tendons and ligaments. The four bones are:

  • Femur – thigh bone
  • Tibia – larger of the two lower leg bones
  • Fibula – smaller of the two lower leg bones
  • Patella – kneecapKnee-Anterior_v2_20141126

As in all joints, the ends of the bones are covered with hyaline (articular) cartilage that protects the ends of the bones and allows them to glide over each other during movement. Loss of this cartilage can lead to osteoarthritis.

The knee can also be seen as consisting of two compartments:

  • One on the inside of the knee (medial)
  • One on the outside (lateral)

Each of these contains a meniscus; a pad of more fibrous cartilage that acts as a shock absorber and helps to stabilise the knee.

The two joints of the knee are:

  • Femoral-tibial – the main knee joint between the femur and the tibia
  • Patellofemoral – between the kneecap and the femur

The femoral-tibial joint is mainly held together by four ligaments:

The two cruciate (cross-shaped) ligaments are found at the centre of the knee and stop the tibia moving too far forwards or backwards, and controls rotation, such as pivoting movements when doing sport. The two collateral ligaments are on the inside and outside of the knee and help attach the femur to the lower leg bones. If any of these ligaments are injured, the knee can become unstable.

In the patellofemoral joint, the kneecap moves in a groove on the femur called the trochlea, and both sides are covered in articular cartilage that eases movement.

Above the knee, the quadriceps (four-headed) muscles of the thigh help to straighten the knee and stop the tibia moving backwards, while the hamstring muscles, at the back of the knee, help to bend the knee and stop the tibia moving too far forwards.


Knee Injuries

Further reading
  • Elattar M, Dhollander A, Verdonk R, Almqvist KF, Verdonk P. Twenty-six years of meniscal allograft transplantation: is it still experimental? A meta-analysis of 44 trials. Knee Surg Sports Traumatol Arthrosc. 2011;19:147-157.
  • Lee BS, Kim JM, Sohn DW, Bin SI. Review of Meniscal Allograft Transplantation Focusing on Long-term Results and Evaluation Methods. Knee Surg Relat Res. 2013;25:1-6.
  • Saltzman BM, Bajaj S, Salata M et al. Prospective long-term evaluation of meniscal allograft transplantation procedure: a minimum of 7-year follow-up. J Knee Surg. 2012;25:165-175.
  • Verdonk PC, Demurie A, Almqvist KF, Veys EM, Verbruggen G, Verdonk R. Transplantation of viable meniscal allograft. Survivorship analysis and clinical outcome of one hundred cases. J Bone Joint Surg Am. 2005;87:715-724.
  • Verdonk R, Almqvist KF, Huysse W, Verdonk PC. Meniscal allografts: indications and outcomes. Sports Med Arthrosc. 2007;15:121-125.
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