![]() It is stronger and more vascular than ACL. Posterior cruciate ligament (PCL) arises from the posterior intercondylar area of the tibia and attaches to the anterior part of the medial femoral condyle (lateral surface). However, the ACL can get torn by sudden pivoting motions of the knee. A newly discovered anterolateral ligament (ALL) works in conjunction with ACL. It also prevents hyperextension of the knee joint and limits rotation and sideways movement of the knee joint. It prevents anterior dislocation of the tibia onto the femur by limiting the forward motion of the tibia. They prevent the femur and tibia from sliding too far forward or backward.Īnterior cruciate ligament (ACL) arises from the anterior intercondylar area of the tibia and attaches to the posterior part of the lateral femoral condyle (medial surface). The paired cruciate ligaments crisscross each other obliquely like a letter “X” within the knee joint. Intracapsular ligaments include cruciate (anterior and posterior) ligaments. It lies deep to the lateral patellar retinaculum and superficial to the popliteal tendon. Lateral (fibular) collateral ligament (LCL) is thin and rounder than MCL that attaches proximally to the lateral femoral epicondyle and distally to the lateral fibular head splitting the biceps femoris tendon. It prevents excessive sideways movement by restricting external and internal rotation of the extended knee. It attaches proximally to the medial femoral epicondyle and distally to the medial tibial condyle. Medial (tibial) collateral ligament (MCL) is a broad and flat ligament that lies on the medial side of the knee joint. Thus, it reinforces the posterolateral part of the joint capsule.Ĭollateral ligaments are two strap-like ligaments providing side-to-side stability of the knee joint and preventing excessive medial or lateral movement. It arches superiorly and medially to attach to the posterior side of the joint capsule of the knee. It reinforces the posterior capsule by blending with it in the central portion.Īrcuate popliteal ligament is a thick, fibrous band arising on the posterior aspect of the fibular head. It is an expanded portion of the semimembranosus tendon that spans the intercondylar fossa. Oblique popliteal ligament (Bourgery ligament) connects the medial tibial condyle with the lateral femoral condyle. ![]() Popliteal ligaments prevent hyperextension of the knee joint. It stabilizes the patella and prevents its displacement. It blends with the medial and lateral patellar retinacula along with the overlying fascia. Patellar ligament (Ligamentum patellae) is a strong, thick fibrous band and a distal continuation of the quadriceps femoris tendon extending from the apex of the patella to the tibial tuberosity. A properly planned procedure-specific RA technique provides optimal analgesia without any motor effects, which helps in early mobilization and discharge, reducing opioid consumption and their side effects significantly.Įxtracapsular ligaments include the patellar, popliteal (oblique and arcuate), and collateral (medial and lateral) ligaments. Among many available RA options, challenges include selecting more procedure-specific, motor-sparing, and opioid-sparing options suitable for enhanced recovery after surgeries (ERAS) protocols. Regional analgesia (RA) is an important component of multimodal analgesia to deal with perioperative pain. A multidisciplinary approach with multimodal analgesia is the demand of time for successful surgical outcomes. Knee surgeries vary from minimally-invasive arthroscopic procedures (in relatively younger populations) to open arthroplasty procedures (in the elderly populations).īefore deciding the analgesia techniques for the postoperative period, knowledge of functional anatomy, surgical steps, pain generation, pain generators, and innervation of the pain generators is essential. Knee surgeries are one of the most commonly performed, life-changing surgical procedures of the modern world, leading to improved health-related quality of life and functional status. As a result, the patient experiences pain, inflammation, and a limitation of the range of motion, finally leading to an impaired gait. The most important structure of the knee joint is its cartilage surface which might get damaged due to trauma, overload, and genetic disorders. The attached muscles and ligaments provide stability and flexibility to the knee joint. During walking and jumping, it is loaded with 7-fold body weight. Being a most stressed joint subject to enormous pressure while providing flexible movement, it is vulnerable to injury. The knee is the biggest and the most complicated joint of the human body.
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