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General principles


OVERVIEW

Chapter synopsis

  • The knee is a complex joint and is a common site of musculoskeletal injury.

  • Understanding basic knee anatomy and physiology is key for providing effective treatment and care.

Important points

  • Knee anatomy

    • Bony anatomy

    • Ligaments and soft tissues

  • Knee biomechanics

    • Tibiofemoral joint kinematics

    • Patellofemoral joint kinematics

    • Meniscus Biomechanics

  • Physical exam

    • Maneuvers to assess the anterior cruciate ligament

    • Maneuvers to assess the posterior cruciate ligament

    • Maneuvers to assess the posterolateral corner and lateral collateral ligament

    • Maneuvers to assess the medial collateral ligament

    • Maneuvers to assess the meniscus

    • Maneuvers to assess for patellofemoral pain and patellar instability

Pearls

  • Understanding basic knee anatomy is essential for the diagnosis of injuries involving the knee.

  • Physical exam maneuvers are a crucial variable when making the diagnosis of knee injuries.

Pitfalls

  • Improper application of physical exam maneuvers can lead to misdiagnosing knee injuries.

Introduction

The knee is one of the most commonly injured joints in the body with a large proportion of injuries occurring in younger patients. As a result, knee pain is one of the most common musculoskeletal causes for presentation to primary care clinics and the emergency department. Having a strong foundational knowledge of the anatomy of the knee, in particular, the bony and soft tissue structures, is critical for proper management and treatment in both the acute and chronic setting. In the subsequent chapters, we outline a number of procedures utilized in the treatment of common bony and soft tissue pathologies of the knee. This chapter serves as a foundational review of the relevant anatomy and mechanics of the knee and concludes with an overview of the focused physical exam for patients with acute and chronic knee trauma.

Basic anatomy

The knee is the largest articular weightbearing surface in the human body and is essential to the function of the lower extremity. The knee comprises two joints, the tibiofemoral joint and the patellofemoral joint, which together help regulate motion across the two largest lever arms in the human body—the femur and the tibia.

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