BIOMECHANICS

OF THE KNEE
GROUP NO 6
 OBJECTIVES
BIOMECHANICS OF KNEE JOINT
KINEMATICS
SURFACE MOTION OF TIBIOFEMORAL JOINT
SURFACE MOTION OF PATELLOFEMORAL JOINT
PF JOINT DYNAMICS
KNEE JOINT STABILITY
PATHOMECHANICS
COMMON INJURIES
BIOMECHANICS
OF THE
KNEE JOINT
The knee joint, also known as the tibiofemoral joint, is a complex and essential joint in the
human body that plays a crucial role in movement, support, and stability. It is a synovial
hinge joint that connects the distal end of the femur (thigh bone) to the proximal end of the
tibia (shin bone), allowing for flexion, extension, and rotation movements.

The knee joint consists of:

1. Bones: Femur, tibia, and patella (kneecap)

2. Ligaments: Anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial
collateral ligament (MCL), and lateral collateral ligament (LCL)
3. Tendons: Quadriceps tendon, hamstring tendons, and calf tendons
4. Muscles: Quadriceps, hamstring, calf, and popliteus muscles
5. Menisci: Two cartilage structures (medial and lateral) that absorb shock and reduce friction
between the bones
6. Joint capsule: A fibrous sac that surrounds the joint, providing additional stability and
support
The knee joint's biomechanics involve the intricate interactions between these structures,
enabling us to perform various activities like walking, running, jumping, and climbing stairs.
Understanding the knee joint's biomechanics is essential for diagnosing and treating injuries,
as well as developing strategies for injury prevention and rehabilitation. The knee joint is a
complex hinge joint that connects the femur (thigh bone) and tibia (shin bone). Its
biomechanics involve the interaction of bones, ligaments, tendons, and muscles to provide
stability, support, and mobility.

Movements:-
• Flexion (bending)
• Extension (straightening)
• Rotation (twisting)

Biomechanical functions:-
• Weight-bearing and transmission of forces from the femur to the tibia
• Stability and support during movement and stationary positions
• Mobility and flexibility for various activities like walking, running, and climbing stairs
Key biomechanical aspects:-

 Joint alignment and tracking

 Ligamentous stability and tension
 Muscle forces and their moment
 Joint reaction forces and contact pressures
 Kinematics (movement patterns) and kinetics (force and motion analysis)

Injuries and conditions:-

 Ligament sprains (ACL, MCL, etc.)

 Tendonitis (quadriceps, hamstring)
 Meniscal tears
 Osteoarthritis
 Patellofemoral pain syndrome
 Kinematics:
•The study of the angular motion of the bones in the joint, particularly
the tibiofemoral joint (TFJ).

 Surface Joint Motion:

KINEMATICS Involves the movement at both the tibiofemoral joint (TFJ) and the
patellofemoral joint (PFJ).
 Impact of Obstructions:
Any restriction in range of motion (ROM) or surface motion disrupts
the normal loading patterns of the joint.
 Planes of Motion:
The knee joint moves in all three planes, with the most significant
movement occurring in the sagittal plane (flexion and extension).
 RANGE OF MOTION OF THE TIBIOFEMORAL JOINT (TFJ)

 Extension to Flexion:
The knee can move from slight hyperextension (-3°) to deep flexion (up to 155°), with an
additional 5-10° possible passively.
 External Rotation (ER):
• In full extension, external rotation is completely restricted.
• Rotational laxity increases in flexion.
• At 30-40° of flexion, external rotation can reach about 18°.
 Internal Rotation (IR):
• At 30-40° of flexion, internal rotation can reach about 25°.
• From 40-120° of flexion, both internal and external rotation remain constant.
• Beyond 120° of flexion, internal and external rotation decreases.
 Abduction and Adduction:
• In full extension, abduction and adduction are completely restricted.
• Passive abduction and adduction increase at 30° of knee flexion.
• Beyond 30° of knee flexion, passive abduction and adduction decrease.
 SURFACE JOINT MOTION OF THE KNEE

 Measurement Methods:
• Stereophotogrammetric Method (Selvik, 1978, 1983)
Uses multiple cameras to track 3D positions of markers on bones.

• Instant Centre Technique (Reuleaux Method, 1876)

Identifies the point around which bones rotate at any instant.

 Tibiofemoral Joint (TFJ):

• Moves in all three planes (sagittal, frontal, and transverse) simultaneously.
• Motion is primarily sliding and rolling, following concave-convex rules.
• Movement is greater in the sagittal plane, with less motion in the transverse and frontal
planes.
 Patellofemoral Joint (PFJ):
• Moves in two planes simultaneously: frontal and transverse.
• Motion is far greater in the frontal plane compared to the transverse plane.
 Helfelt test:
To check the external rot of tibiofemoral joint during knee
extension

SURFACE (Screw home mechanism):The screw home mechanism

refers to the automatic rotation of the tibia on the femur during
MOTION OF the final degrees of knee extension, locking the knee in place
and providing stability.
TIBIOFEMORAL
*Extension Phase: *As the knee moves from flexion (bent) to
JOINT full extension (straight), the tibia externally rotates

*Flexion Phase: *During knee flexion, the tibia internally

rotates to unlock the knee, allowing for smooth bending.
 1. *Early Flexion*:
As the knee starts to bend, the back surface of the patella
(kneecap) begins to touch the thigh bone (femur).
2. *From 30° to 90° of Flexion*:- The patella glides
downward. - Both the inner (medial) and outer (lateral)
SURFACE MOTION surfaces of the patella make contact with the femur.
3. *Beyond 90° of Flexion*:- The patella starts to
OF rotate outward. The patella moves into the groove between
the two rounded ends of the femur. Contact is divided into
PATELLOFEMORAL separate points on the medial and lateral surfaces of the
patella.
JOINT 4. *At Full Flexion*:- The patella settles deeply into
the groove of the femur, making secure contact.

These motions are critical for the smooth functioning and

stability of the knee joint during movements.
 The dynamics of the knee joint refers to the study of forces and torques
that cause motion at the knee, including both the internal forces (muscles,
tendons, ligaments) and external forces (gravity, ground reaction forces)
acting on the joint. It encompasses how these forces interact to produce
movement and how they affect the stability and function of the knee
during various activities.
DYNAMICS 1.Forces and Torques:
OF • Internal Forces: Generated by muscles (e.g., quadriceps, hamstrings).
PF JOINT • External Forces: Include body weight and ground reaction forces.
• Joint Reaction Forces (JRF): Forces within the joint in response to
external and muscle forces.
• Ground Reaction Forces (GRF): Forces from the ground during
activities like walking.
2.Moment Arms:
• Distance from the knee joint axis to the force line, determining torque.
3. Acceleration:
•Linear and angular acceleration affecting knee motion speed and direction.
4. Mass Moment of Inertia:
•Resistance of the knee joint to changes in rotational speed, based on mass distribution.
DYNAMICS OF THE KNEE JOINT
1. Muscle Force and Joint Reaction:
The more force the muscles around the knee produce, the greater the force within
the knee joint.
2. Knee Flexion and Quadriceps Force:
Bending the knee (knee flexion) increases the force exerted by the quadriceps
muscle, which in turn increases the force in the knee joint.
3. Standing Relaxed:
When standing relaxed, the quadriceps muscle exerts minimal force.
4. Walking on Level Ground:
Walking on flat ground requires only a little knee bending and results in low forces
within the knee joint.
4. Knee Flexion to 90 Degrees:
Bending the knee to a 90-degree angle increases the force in the knee joint to 2.5 to 3 times
your body weight.
5. Climbing Stairs:
Climbing stairs requires more knee bending, with the knee bending up to 60 degrees,
generating forces up to equal to your body weight.
DYNAMICS OF THE PATELLOFEMORAL JOINT (PFJ)
1. Patella Position in Extension:
When the knee is extended, the patella rests against the femur.
2. Patella Position in Flexion:
At 90 degrees of knee flexion, the contact point between the patella and femur moves
upward.
3. Contact Surface Area:
As the contact area increases during flexion, it helps distribute and compensate for the
increased force in the PFJ.
4. Impact of a Tight IT Band:
A tight iliotibial (IT) band pulls the PFJ force laterally, causing abnormal movement and load
distribution.
5. High Forces in Flexion:
High quadriceps force and torque during deep knee flexion can lead to patellar fractures,
common in activities like basketball and weightlifting.
6. Activity Recommendations:
Patients with PFJ issues should limit activities that involve deep knee flexion in their daily
activities.
 What is Knee Joint Stability?
Knee joint stability is how well your knee stays in place and moves
without feeling unstable or giving way.

Why is it Important?
It helps you walk, run, jump, and perform daily activities without pain or
injury.
KNEE
JOINT Key Parts of Knee Stability:
STABILITY 1.Muscles: Strong muscles around the knee, like the quadriceps and
hamstrings, provide support.
2.Ligaments:Ligaments are tough bands of tissue that connect bones. Key
ligaments for knee stability include the ACL (anterior cruciate ligament)
and PCL (posterior cruciate ligament).
3.Tendons:Tendons attach muscles to bones and help control knee
movements.
Preventing Knee Injuries:
Warm-Up: Always warm up before physical activities.- Proper Footwear: Wear shoes that
provide good support.
Avoid Overuse: Don’t overdo activities that put a lot of stress on your knees.
Range of Motion in the Knee:
Flexion: Bending the knee (up to about 135 degrees).
Extension: Straightening the knee (up to 0 degrees, sometimes a few degrees beyond).

Improving Knee Stability and Range of Motion:

1. Strengthening Exercises: Focus on leg muscles, particularly around the knee.
2. Flexibility Exercises: Regular stretching to maintain flexibility.
3. Balance Training: Activities like yoga or balance drills.
4. Proper Technique: Use correct form during exercises and activit
The primary ligaments responsible for knee joint stability are:
1. Anterior Cruciate Ligament (ACL):
Prevents the tibia from sliding out in front of the femur. -
Provides rotational stability to the knee.

2. Posterior Cruciate Ligament (PCL)

Prevents the tibia from sliding backward under the femur.
Is stronger than the ACL and provides stability, especially during backward movement.

3. Medial Collateral Ligament (MCL)

Runs along the inside of the knee.
Prevents the knee from bending inward (valgus stress).

4. Lateral Collateral Ligament (LCL)

Runs along the outside of the knee.
Prevents the knee from bending outward (varus stress).
 GENU VALGUM AND GENU VARUM:

PATHOMECHANICS

decreased increased

10 to 15 degree.
Excessive genu valgum causes weight bearing on lateral side during walking while genu
varum causes weight on medial side.
Factors contributing to genu valgum are adductor muscles tightness , IT band tightness foot
pronation Femoral anteversion.
Excessive genu varum causes weight bearing on the medial side.
Contributing factors are femoral retroversion muscles weakness etc.

ROTATORY DYSFUNCTION:
Causes of decreased external tibial rotation:
Biceps femoris and tensor fascia latae were external rotators of the tibia, meniscus
displacement ,capsule tightness surgery specially due to which mcl may heal or shortening.

Effects of full knee extension in absence of normal rotation:

Deformation of articular surfaces and on medial joint surfaces and also increased tensile
force on ACl ( tight in extension or internal rotation).
 CAPSULAR TIGHTNESS:

Capsule provide stability due to

mechanoreceptors which sense the position
And activated a muscles for the stability.

After surgery or any trauma scar tissues develop

Which cause tightness of the knee capsule
Which decreases flexibility of knee joint
KE limited by 20-30 degree
KF limited by 80-90 degrees
Ambulation is most altered.
 BUCKET HANDLE TEAR
With a bucket handle tear, a tear forms in the center of your meniscus. This opening pushes
the inside edge of your meniscus toward the middle of your knee. Because the ends of the
meniscus are still attached to the knee joint and the outer edge remains curved, it looks like a
handle on a bucket.
Twisting your knee while running or pivoting may cause a bucket handle meniscus tear.
Inability to straighten your leg completely.
Knee pain.
Knee locking, catching or feeling like you can’t move your knee.
Popping sound at the time of the injury.
Stiffness and swelling in your knee.
KE is limited or ACL stretching.
(torn portion will get stuck in the joint space
of the meniscus.)
 1. PATELLOFEMORAL PAIN
SYNDROME (PFPS)

Description: Often referred to as

“runner’s knee,” PFPS is characterized
by pain around the kneecap (patella)
COMMON where it meets the thighbone (femur).

INJURIES Causes: Overuse, misalignment of the

patella, muscle imbalances, or trauma.

Symptoms: Dull, aching pain in the front

of the knee, especially when sitting with
bent knees, squatting, or using stairs.
Treatment: Rest, physical therapy, pain
relievers, and orthotics for improved
knee alignment.
2. ANTERIOR CRUCIATE LIGAMENT
(ACL) INJURY

Description: The ACL is a key ligament that

helps stabilize the knee. An ACL injury
involves a partial or complete tear of this
ligament.

Causes: Sudden stops, changes in direction,

landing improperly from a jump, or direct
contact.

Symptoms: A popping sensation, severe pain,

swelling, and instability.

Treatment: Rest, bracing, physical therapy, and

often surgery, especially for athletes or those
3. MEDIAL COLLATERAL LIGAMENT
(MCL) INJURY

Description: The MCL is located on the inner side of

the knee and provides stability by connecting the
femur to the tibia.

Causes: Direct blow to the outside of the knee,

causing the knee to bend inward.

Symptoms: Pain, swelling, and tenderness along the

inside of the knee, and a feeling of instability.

Treatment: Rest, ice, compression, elevation (RICE),

physical therapy, and sometimes bracing. Surgery is
rare unless other knee structures are also damaged.
4. Meniscal Tear

Description: The meniscus is a piece of cartilage that

provides cushioning between the femur and tibia. A
meniscal tear is a rupture of this cartilage.

Causes: Twisting or turning quickly, especially with

the foot planted and the knee bent, or through direct
contact.

Symptoms: Pain, swelling, stiffness, and difficulty

extending the knee fully. A catching or locking
sensation may also occur.

Treatment: Rest, ice, physical therapy, and sometimes

surgery, depending on the tear’s severity and location.