Remarks on the anatomy of the knee-joint / by Holmes Coote.

  • Coote, Holmes, 1817-1872.
Date:
[1850]
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the anatomy of the knee-joint / by Holmes Coote. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ON THB ANATOMY OP THE KNEE-JOINT. By holmes COOTE, F.K.C.S. DEMONSTRATOR OF ANATOMY AT ST. BARTHOLOMEW’S HOSPITAL, AND LATE PRESIDENT OF THE AUERNETHIAN SOCIETY. Read on Vmrsday, November 7, 1850. The thigh, Jwhich may he freely flexed upon the pelvis, as in the act of raising the knee, cannot he extended back- wards beyond a perpendicular line drawn from the acetabulum through the long axis of the inferior extremity. The leg, on the other hand, cannot be ex- tended beyond a similar line, hut may he flexed to almost any extent upon the thigh. The movements in the one , joint’are precisely the opposite to those in the other. In the upright position the bones composing the knee-joint am held by the ligaments, as well as by the muscles, immoveahly fixed, so that the limb may constitute a firm column of support to the weight of the trunk ; but in the semiflexed position the tibia is capable of rotating to a limited extent upon the articulating extremity of the femur. The number, direction, and points of i attachment of the ligaments of the 1 knee-joint have a direct relation to these three points: namely, the free- t dom of flexion; the firmness of the ’ whole limb in its extended position; I and the power of rotation, to a Limited < extent, when the leg is bent upon the I thigh. Flexion.—Tire jrrominent and hoii- izontally elongated condyles of the fe- imur have their articulating smTaces continued backwards to the shaft of the 1 hone, that the shallow head of the tibia may freely move in the common flexion of the leg, as in the act of walking, run- ning, &c. Most persons, and indeed all by practice, can, with a slight efibit and with the assistance of the hand, make the extremity of the os calcis, or the heel, touch the buttock opposite the tuberosity of the ischium. If, in the dead subject, the mechanical obstruc- tion offered to exti-eme fle.xion by the muscles of the calf of the leg, and by the hamstring muscles, be removed, the approximation of the heel and buttock is the more easy. It is therefoi'e irra- tional to talk of any ligaments being concerned in checking a movement which the mechanical construction of the joint allows in its fi-eest range. The only tension observed is in the fold of synovial membrane, and in a few stray ligamentous fibres, covering the ante- rior surface of the crucial ligaments; but the resistance thus offered is incon- siderable, and maybe overcome without damage to the ligamentous structures of the knee. Extension.—The leg cannot be ex- tended beyond a sti-aight line drawn perpendicularly through the long axis of the inferior extremity. In complete extension all the ligaments are tense; and an attempt to force the leg beyond this line would rupture, first, the liga- mentum posticum Winslowii; secondly, the two lateral ligaments; and thirdly, the two crucial ligaments. In the li ring subject the resistance offered by the