Patellofemoral Anatomy
The femororotulian joint situated on the anterior side of the knee is made up of the kneecap and the femoral trochlea as joint components. It works as a reflection pulley through the flexo-extension movements of the knee similar to the way a mechanical pu
- PDF / 801,377 Bytes
- 6 Pages / 504.57 x 720 pts Page_size
- 31 Downloads / 223 Views
Patellofemoral Anatomy Pedro Guillen-Garcia, Vicente Concejero-Lopez, Jose F. Rodriguez-Vazquez, Isabel Guillen-Vicente, Marta Guillen Vicente, and Tomas F. Fernandez-Jaén
Contents 3.1 Introduction ...................................................
11
3.2 Morphology ...................................................
11
3.3 Patellar (Kneecap) Cartilage .......................
15
References ...............................................................
16
3.1
The femororotulian joint situated on the anterior side of the knee is made up of the kneecap and the femoral trochlea as joint components. It works as a reflection pulley through the flexo-extension movements of the knee similar to the way a mechanical pulley slides, the kneecap being the footing for the transmission of forces. The femororotulian joint has been the forgotten compartment of the knee for quite a while now. Its anatomy (Fig. 3.1), biomechanics, and function are well known, but there are unfinished business: 1. The origin of pain; the true value of cartilage damage 2. The adequate diagnostic means 3. The reliability of surgical techniques In this chapter, we will try to explain all the relevant anatomical data that explain the femororotulian biomechanics and pathology.
3.2
P. Guillen-Garcia (*) • V. Concejero-Lopez J.F. Rodriguez-Vazquez • I. Guillen-Vicente M.G. Vicente • T.F. Fernandez-Jaén Trauma Unit, Clinica Cemtro, Madrid, Spain e-mail: [email protected] A. Gobbi et al. (eds.), The Patellofemoral Joint, DOI 10.1007/978-3-642-54965-6_3, © ISAKOS 2014
Introduction
Morphology
According to Jiménez Collado, P Guillen Garcia, and Sobrado Perez [1], the kneecap can be studied theoretically through its anterior or superficial side, posterior side, and deep or articular side and also through its upper or base rim, lower vertex or angle, and lateral rims. On the morphological level, the kneecap is a transverse edged trochlear arthrosis with a degree of freedom of movement. The arrangement of the 11
12
Fig. 3.1 Schematic view of the anterior side of right kneecap and boundaries (Licensed by Jimenez Collado et al. [1])
femoral trochlea and the deep articular side determines the degree of the kneecap lateral instability during the first degrees of bending and the major overload of one of its articular sides on the other. Wiseber classification is prototypical: type I, both articular sides are concave and significantly of the same amplitude; type II, lower internal concave side than the external one; and the most common of all, type III, internal convex side with a small surface borderlining patellar hypoplasia. On the other hand, the normal trochlear angle is 140°; larger angles cause a greater degree of lateral instability; lower angles are more likely to cause cartilage involvement (Fig. 3.2). When it comes to the femur, the rotulian cartilage footing on the femoro-trochlear cartilage can be established according to the various degrees of bending [1, 3]: • From 0° to 10°: Only the rotulian cartilage lower part contacts the t
Data Loading...
