Lecture Notes: Ligaments of the Knee

Key Ligaments of the Knee

1. Collateral Ligaments

   • Medial Collateral Ligament (Tibial Collateral) and Lateral Collateral Ligament (Fibular Collateral)
     • Medial Collateral:
       • Proximal attachment: medial epicondyle of the femur
       • Distal attachment: tibia
       • Located above the insertion of sartorius, gracilis, and semitendinosus
       • Mnemonic for insertion points: SGT (Sartorius, Gracilis, Semitendinosus) - collectively known as pes anserinus
     • Lateral Collateral:
       • Proximal attachment: lateral epicondyle
       • Distal attachment: lateral part of the head of the fibula

2. Cruciate Ligaments

   • Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL)
     • These ligaments cross each other, hence the term 'cruciate' (Latin: cross)
     • ACL:
       • Proximal attachment: lateral wall of the intercondylar fossa
       • Function: Prevents the tibia from sliding forward
     • PCL:
       • Proximal attachment: medial wall of the intercondylar fossa
       • Function: Prevents the tibia from sliding backward

3. Patellar Ligament

   • Continuous with quadriceps femoris tendon
   • Attaches to patella and distally to tibial tuberosity

Joint Capsule of the Knee

• Fibrous Membrane and Synovial Membrane
  • Reinforced by various ligaments:
    • Medially by medial collateral ligament
    • Anteriorly blends with patella ligament
    • Strengthened by retinacula from vastus medialis and vastus lateralis
    • Laterally reinforced by iliotibial tract, with a space for the fibula bursa under the fibular collateral ligament
  • Oblique Popliteal Ligament
    • Extension from semimembranosus tendon reinforcing the posterior aspect

Synovial Membrane

• Forms bursae:
  • Suprapatellar Bursa: Above the patella
  • Subpopliteal Recess: Between popliteus tendon and lateral meniscus
  • Other notable bursae:
    • Infrapatellar Fat Pad: Underneath patella ligament separating it from synovial membrane
    • Pre-patella Bursa: Over the kneecap
    • Deep Infrapatellar Bursa: Underneath patella ligament
    • Superficial Infrapatellar Bursa: On top of the patella ligament
• Cruciate ligaments are not enclosed within the articular cavity

Additional Points

• Multiple smaller bursae present over tendons and ligaments
• Synovial membrane folds to accommodate movement and protect structures

The lecture covers the structure, attachment, and function of knee ligaments and the components of the knee joint capsule, emphasizing the relationships and protection provided by the synovial and fibrous membranes.