BIOMECHANICS FILE WORK

Describe Kinematics of medial/lateral rotation at tibiofemoral joint.

BY: APOORV GARG
B. P. T. 2ND YEAR
ROLL NO. 04
20TH BATCH

INTRODUCTION

GENERAL FEATURES OF TIBIOFEMORAL JOINT

1. It is Double Condyloid joint with 3⁰ degrees of Angular

Motion.
2. Flexion/Extension
Plane-Sagittal Plane
Axis- Coronal Axis
3. Medial Rotation/Lateral Rotation
Plane- Transverse Plane
Axis – Longitudinal Axis
4. Abduction/Adduction
Plane-Frontal Plane
Axis -Antero-Posterior Axis
 Femoral Articular Surface

1. Femur is proximal articular surface of the knee joint

with large medial and lateral condyles.
2. Because of the obliquity of the shaft, the femoral
condyles do not lie immediately below the femoral
head but are slightly medial to it.
3. The medial condyle extend furthur distally, so
that,despite the angulation of the femur shaft’s, the
distal end of the femur remains essentially horizontal.
4. In sagittal plane- Condyles have a convex shape
5. In frontal plane- Slight convexity.
6. The lateral femoral condyle shifted anteriorly in
relation to medial articular surface is shorter.
Inferiorly, the lateral femoral condyle appears to be
longer.
7. The two condyles are separated :
Inferiorly by Intercondylar arch
Anteriorly by an asymmetrical, shallow groove called
Patellar Groove or Surface.
 Tibial Articular Surface

1. Asymmetrical medial and lateral tibial condyles constitute the

distal articular surface of knee joint.
2. Medial tibial plateau is longer in Antero-posterior direction as
compared to lateral one.
3. The lateral tibial articular cartilage is thicker than the medial
side.
4. Tibial plateau slopes approximately 7⁰ to 10⁰.
5. Medial and Lateral tibial condyles are separated by two bony
spines called Intercondylar tubercules.
6. The tibial plateaus are predominantly flat, but convex at
anterior and posterior margins. Because of lack of this bony
stability, accesory joint structures are necessary to improve the
joint.
KINEMATICS OF MEDIAL/LATERAL ROTATION
AT TIBIOFEMORAL JOINT.
1. OSTEOKINEMATICS
 The medial and lateral rotation at tibiofemoral joint are
angular motions that are named for the relative motion of
tibia on femur.
 These axial rotations occur about a longitudinal axis that runs
through or close to the medial tibial intercondylar tubercle.
 The medial and lateral rotation are available because of
articular incongruence and ligamentous laxity.
 Consequently, the range of tibiofemoral joint rotation
depends on the position of the knee.
 When the knee is in full extension, it is in the closed packed
position and ligaments are taut, i.e. no axial rotation is
possible. The tibial tubercles are lodged in the intercondylar
notch and the menisci are tightly interposed between the
articulating surfaces.
 As the knee flexes increasingly toward 90⁰, the capsule and
ligaments become more lax. The tibial tubercles are no
longer in the intercondylar notch and the condyles of the tibi
and femur are free to move on each other.
 The maximum range of axial rotations is available at 90⁰ of
knee flexion, with the magnitude of axial rotation
diminishing as the knee approaches both full extension and
full flexion.
  Range of motion of Lateral Rotation- 0-20⁰
 Range of motion of Medial Rotation- 0-15⁰

2. ARTHROKINEMATICS
 During the axial rotations of tibiofemoral joint, the
longitudinal axis for motion lies at the medial intercondylar
tubercle.
 Consequently, the medial condyles act as the pivot joint
while the lateral condyles move through a greater arc of
motion than the medial regardless of the direction of rotation
 During Tibial lateral rotation on femur
The medial tibial condyle moves only slightly anteriorly on
the relatively fixed medial femoral condyle while the lateral
tibial condyle moves a large distance posteriorly on the
relatively fixed lateral femoral condyle.
 During Tibial medial rotation on femur
The medial tibial condyle moves only slightly posteriorly
on the relatively fixed medial femoral condyle while the lateral
tibial condyle moves a large distance anteriorly on the
relatively fixed lateral femoral condyle.
 During Femoral lateral rotation on tibia
The lateral femoral condyle moves posteriorly on the lateral
tibial condyle while the medial femoral condyle moves
slightly anteriorly on the relatively fixed medial tibial
condyle.
 During Femoral medial rotation on tibia
The lateral femoral condyle moves anteriorly on the lateral
tibial condyle while the medial femoral condyle moves
slightly posteriorly on the relatively fixed medial tibial
condyle.
 With the center of rotation located within the medial tibial
plateau, the contact forces are focused on a smaller area on
the medial tibial condyle whereas the contact forces are
distributed over a larger surface area on the lateral tibial
condyle.
 During both medial and lateral rotation, the knee joint’s
menisci will distort in the direction of movement of the
corresponding femoral condyle, and therefore, maintain their
relationship to the femoral condyles just as they did in
flexion and extension.
 For example- As the tibia medially rotates, the medial
meniscus will distort anteriorly on the tibial condyle to
remain beneath the relatively anteriorly moving medial
femoral condyle, and the lateral meniscus will distort
posteriorly to remain beneath the posteriorly moving lateral
femoral condyle. In this way, the menisci continue to reduce
friction and distribute forces without restricting motion of
the femur, as more and more solid or rigidly attached
meniscal structures would do.
MEDIAL AND LATERAL ROTATION OF TIBIOFEMORAL
JOINT IN BOTH OPEN AND CLOSED CHAIN KINEMATICS.
THANK
YOU