Knees. The largest joints in the body – they carry almost our entire weight and absorb the highest impact loads of any part of the skeleton. We need them to walk, sit, run, hop, climb, jump, squat, lift and kneel. In other words, getting by without a knee or two is going to seriously dent your daily activities. And, as far as joints go, knees live up to the reputation of the bigger they are, the harder they fall.
From a technical point of view, the knee is a mobile trocho-ginglymus, permitting flexion and extension plus a slight internal and external rotation. What does that mean? It means the knees – as you probably guessed – can move backwards and forwards and we can do a pivot on them – within reason. And to do all that, the knee needs to be a lot more than just a place in between the thigh and leg.
The knee consists of the patella (the kneecap) the patella groove at the base of the femur (the thigh bone) and the medial and lateral articulations that sits the femur on top of the tibia (the largest leg bone). But that’s just the bones. Keeping these bones lubribated and seperate from one another is a whole lot of synovial fluid contained within a capsule known as the synovial membrane. Two discs – the menisci – similar to the discs found in the spine, sit between the point of contact of the femur and tibia, acting as the primary shock absorbers in a joint that has an impact load three times that of your body weight.
Then there’s the bits that allow all the movement in knee. There’s the eleven ligaments – including the well known cruciate ligaments and the lessor known medial collateral and the oblique popliteal that hold the knee together. The power to bend, pivot and extend comes from the fourteen muscles including the biceps femoris, quadraceps, plantaris and the Semimembranosus – I threw in the last one because it’s got the longest name.
All up, just one knee joint contains thirty-one moving or flexible parts – and like any machine, that’s a whole lot of things to wear out, break down or stop working. Little wonder there were 44,500 knee replacements in Australia during 2010, nearly fifty percent more than the number of hip replacements that same year. In the United States, eleven million people over the age of forty visit their doctor every year to have knee pain or injuries treated.
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