On the other hand, to the medial collateral ligament is attached a deep plane formed of fibers, which, descending from the femur and rising from the tibia, must be attached to the medial myelium by fusion with the capsule; thus the connections of this Mediterranean are strengthened by the capsule.

In contrast, the medial side is separated from the capsule in its middle part. passage of the popliteus tendon. Anterior cruciate ligament. - It is born on a pre-tubular surface, between the front brake inserts of the two medals, goes back, outwards and slightly higher and ends, in a vertical line, at the rear of the axle surface. lateral condyles.

This ligament sends out an extension in its initial part, which must be secured to the anterior horn of the lateral medial. Posterior cruciate ligament. - Vertical, originating from the reticular surface, where it represents the posterior insertions of the posterior ligaments of the medinas, rises upward, forward and slightly inward and ends in a horizontal line on the anterior part of the axial face of the medial condyle. Like the other cross, it sends in its initial part an extension, which must be fixed on the posterior horn of the same lateral American.

It mainly has connections with crosses. Finally, a fully retractable beam is described on this posterior cruciate ligament and is mounted to be inserted into the posterior aspect of the axial surface of the medial condyle. It is said to be an uncrossed ray because it is more posterior than the most receding part of the anterior cross.

The anterior and posterior ligaments are essentially muscular additions: in the front, for the most part, it is the termination of the quadriceps muscle; back, it's fibrous rear end, consisting of various formations. From the number - a strong medial expansion of huge muscles. On the other hand, the patellar ligament is separated first from the anterior surface of the capsule by a fat pack and then from the anterior surface of the tibia by a serious purse.

It ends on a lateral sloping ridge that begins with the tuberculosis of the leg. These fibers strengthen the circumflex fascia of the limb into which they are woven. It is formed in the midline, in depth, by crossed ligaments, and on each side by a capsular thickening running from the upper border of the femoral condyle to the posterior border of the corresponding tibial condyle: the muscular membranes. The lateral soap shell is strengthened similarly by the two tendons of the lateral gastrocnemius muscle. One of the types of tibia, the other of fibular origin, converges to the apex of the settler shell, at the level of the half-cover of this shell.

The two ribs of the arch are united by a thin fascia covering the fascia of the popliteal muscle. In fact, between the two branches of the popliteal ligament, the capsule is insufficient and replaced by the popliteus muscle. This separates the synovium, which is in front of him, his repair fascia, behind. Under this name we will include the thickened parts of the capsule, which are all attached to the kneecap. The medial wing of the patella is a triangular fibrous mat with the medial condyle inserted directly posterior to the origin of the accompanying tibial ligament with the base anchored along the medial edge of the patella.

This helps keep the patella inward during contraction of the quadriceps muscle. The lateral renal retinaculum, much less developed, is useless in practice. The lateral and medial patellar ligaments extend from the lateral edges of the kneecap to the anterior part of the convex side of the medial side.

4th intrapatellar fat body. - This is a special formation, the remnants of an old division that existed between the two femoral-tibial joints. Within the capsule, this fat body should be viewed both from the front and in profile: in front it is triangular with an apex attached to the lower, extra-articular part of the posterior surface of the patella, and a base that extends over the pretuberculous surface of the tibia, over the transverse ligament of the knee and is lost in laterally on the anterior edge of the tibial condyles.

In profile we see that the fat pad plunges deep into the depths and that it still has a triangular aspect, with the anterior base of the patella tense to the transverse patellar ligament and the posterior apex inserted into the largest part of the intercondyle. This fat body is completely extra blue.

It has a complex shape due to the presence of the media, crossed ligaments and fat body. Overall, however, it is a severe sleeve from the femur to the shin and pierced at the top of the front face with an opening for the patella. But this sleeve, especially on the anterior face of the femur, reflects at the level of the capsular insert to return to the cartilage limit. Thus, above the trochloe there is a dead end.

Now this said sub-quadricipital impasse often communicates with a child, almost always in an adult, with a serious sub-quadricipital purse located above. And the opening of the connection expands with age. Therefore, we usually find a subquadrification dead end of great depth.

On the other hand, in the transverse direction the synovium is interrupted at the level of the targets from which the markings are extinguished. In addition, the posterior surface of the synovium seems to be pushed forward by cruciate ligaments, and its anterior side seems to be pushed away by the fat pad, so that there is only a small synovium filled with paint between the posterior edge of the fat pad and the anterior border of the anterior cruciate ligament. In short, we find two lateral and medial beto-tibial synovial groups, each very partially divided by the medial, exchanging with each other behind the fat pad and meeting above it and continuing with the patlofemoral synovium, which appears to have a large subquadrification cul-de-sac.

This synovium reports: with the usual exchange on the gastrocnemius muscle and on the semi-infinite, with the purse of the popliteus muscle, with the subquadricital bursa. It sends strains, some tendon, then lateral, others median, between the crosses, which can be the source of popliteal cysts.

Just one very important fact: the presence behind the posterior fibrous posterior part of the vasculo-nervous popliteal bundle. Since the artery is the deepest organ, it should be avoided during any knee surgery. Numerous rows occur near the joint, but do not communicate with the synovium. Most of them are attached to muscle tendons.

However, we will mention the preopercular bursae, one subcutaneous, the other extensive when enlarged, which may be the site of hygroma, which too superficial an examination should not be mistaken for hygrothosis. Epiphyseal cartilages. The only important significance here is the cartilage of the junction of the distal femoral epiphysis: it is extra-articular, but in intimate relations, forward, with a subquadrific impasse.

In fact, in flexion there is a combination of a rolling movement and a sliding movement: a bearing is made in the femoral joint, and as the condyles decrease in width from front to back, the medicinal approach to reducing the myci-tibial cavity in flexion, and they go into expansion. In the course of a sharp and righteous expansion, a woman may come to crush a woman who did not slip in quickly enough: this is, for example, defeat by young man which is observed in football players. During flexion, the tibia presents a rotational motion in and vice versa during extension, and this is due to the greater posterior length of the medial femoral condyle.

(2) In semiflexion, where the crossed ligaments are less dense, small movements of rotation and laterality are possible. Patellofemoral pain is one of the most common causes of anterior knee pain in adolescents and adults. Due to its complex etiology, multifactorial and still poorly understood, its management is an important task for the practitioner. Diagnosis is made primarily by history and clinical examination of the knee, but also of the entire lower limb, which may sometimes require imaging.

Treatment in most cases is conservative, mainly focusing on rehabilitation through targeted and personalized physical therapy. Surgical treatment reserved for cases with a causal structural abnormality.