*I am not gonna explain the entire anatomy of the knee here, coz u will find that in hundreds of books. I am gonna post a video made by Dr. Bertram Zarins of the Mass General Hospital Sports Medicine Service, which has made me happy (happy because of its simplicity and beauty in explaining the basic anatomy). Sometimes you try explaining hundreds of things to students without a picture or video and they dont get it, but u show them a beautiful video or picture and they dont need you. This is one of those videos. Point to note is that the doctor was trying to explain Anterior cruciate ligament repair here and not anatomy.
Things to understand from this video :
1. The Anterior cruciate ligament ACL originates from deep within the notch of the distal femur. Its proximal fibers fan out along the medial wall of the lateral femoral condyle. There are two bundles of the ACL—the anteromedial and the posterolateral, named according to where the bundles insert into the tibial plateau. The ACL attaches in front of the intercondyloid eminence of the tibia, being blended with the anterior horn of the medial meniscus. These attachments allow it to resist anterior translation and medial rotation of the tibia, in relation to the femur.
2.The posterior cruciate ligament (or PCL) is one of the four major ligaments of the knee. It connects the posterior intercondylar area of the tibia to the medial condyle of the femur. This configuration allows the PCL to resist forces pushing the tibia posteriorly relative to the femur.
3. Medial collateral ligament : It is a broad, flat, membranous band, situated slightly posterior on the medial side of the knee joint. It is attached proximally to the medial condyle of femur immediately below the adductor tubercle; below to the medial condyle of the tibia and medial surface of its body. It resists forces that would push the knee medially, which would otherwise produce valgus deformity.
4. Lateral collateral ligament : Rounded, more narrow and less broad than the medial collateral ligament, the fibular collateral ligament stretches obliquely downward and backward from the lateral epicondyle of the femur above, to the head of the fibula below. In contrast to the medial collateral ligament, it is fused with neither the capsular ligament nor the lateral meniscus. Because of this, the lateral collateral ligament is more flexible than its medial counterpart, and is therefore less susceptible to injury. The fibers of the posterior part of the ligament are short and incline backward as they descend; they are inserted into the tibia above the groove for the semimembranosus muscle.The anterior part of the ligament is a flattened band, about 10 centimeters long, which inclines forward as it descends.It is inserted into the medial surface of the body of the tibia about 2.5 centimeters below the level of the condyle. It resists forces that would push the knee laterally, which would otherwise produce a varus deformity.
*Other important structures related to knee anatomy are the menisci of the knee and the bursa surrounding the knee, which i am gonna discuss in another post someday.
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Now try answering these Multiple choice questions (mcqs):1.Posterior Cruciate ligament prevents
a.Anterior movement of tibia in relation to femur
b.Posterior movement of tibia in relation to femur
c.Medial movement of tibia
d.Lateral movement of tibia
2.Anterior cruciate ligament prevents
a.Anterior movement of tibia in relation to femur
b.Posterior movement of tibia in relation to femur
c.Medial movement of tibia
d.Lateral movement of tibia
3.Medial collateral ligament prevents
a.Anterior movement of tibia in relation to femur
b.Posterior movement of tibia in relation to femur
c.Medial movement of tibia
d.Lateral movement of tibia
4.Lateral collateral ligament prevents
a.Anterior movement of tibia in relation to femur
b.Posterior movement of tibia in relation to femur
c.Medial movement of tibia
d.Lateral movement of tibia
5.What are the two bundles ACL is made up of
a.Anteromedial and posterolateral
b.Posteromedial and anterolateral
c.Mediolateral and cephalocaudal
d.None of the above
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