1. Ligament Balancing in Total Knee Arthroplasty Section 1 | Anatomy of the knee ligaments

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4. 1.0 – Overview The surgeon’s anatomical perspective
[Fig 1.0.1a] Bony landmarks and ligament/muscle attachments on the anterior aspect of the knee.

5. 1.0 – Overview The surgeon’s anatomical perspective
[Fig 1.0.1a] Bony landmarks and ligament/muscle attachments on the anterior aspect of the knee.

6. 1.0 – Overview The surgeon’s anatomical perspective
[Fig 1.0.1a] Bony landmarks and ligament/muscle attachments on the anterior aspect of the knee.

7. 1.0 – Overview The surgeon’s anatomical perspective
[Fig 1.0.1a] Bony landmarks and ligament/muscle attachments on the anterior aspect of the knee.

8. 1.1 – Medial aspect of the knee The deep medial layer
[Fig 1.1.1] Anatomic specimen after removal of medial capsule with distal part of the vastus medialis muscle, superficial MCL, and pes anserinus. Now displaying the deep MCL.

9. 1.1 – Medial aspect of the knee The deep medial layer
[Fig 1.1.1] Anatomic specimen after removal of medial capsule with distal part of the vastus medialis muscle, superficial MCL, and pes anserinus. Now displaying the deep MCL.

10. 1.1 – Medial aspect of the knee The middle medial layer
[Fig 1.1.2a] Anatomic specimen after removal of the medial capsule and the distal part of the vastus medialis muscle.

11. 1.1 – Medial aspect of the knee The middle medial layer
[Fig 1.1.2a] Anatomic specimen after removal of the medial capsule and the distal part of the vastus medialis muscle.

12. 1.1 – Medial aspect of the knee The middle medial layer
[Fig 1.1.2b] Dorsal aspect of the knee joint with the five different capsular and tendinous attachments of the semimembranosus muscle.

13. 1.1 – Medial aspect of the knee The middle medial layer
[Fig 1.1.2c] The semimembranosus muscle has a direct attachment to the posteromedial corner of the tibia. The attachment can be located posteriorly to the oblique fibers of the superficial MCL and by retracting the pes anserinus.

14. 1.1 – Medial aspect of the knee The middle medial layer
[Fig 1.1.2c] The semimembranosus muscle has a direct attachment to the posteromedial corner of the tibia. The attachment can be located posteriorly to the oblique fibers of the superficial MCL and by retracting the pes anserinus.

15. 1.1 – Medial aspect of the knee The superficial medial layer
[Fig 1.1.3] Tibial attachment of the pes anserinus.

16. 1.1 – Medial aspect of the knee The superficial medial layer
[Fig 1.1.3] Tibial attachment of the pes anserinus.

17. 1.2 – Lateral aspect of the knee The deep and middle lateral layer
[Fig 1.2.1a] Anatomic specimen of the extended knee after the lateral capsule and the complete iliotibial band has been removed.

18. 1.2 – Lateral aspect of the knee The deep and middle lateral layer
[Fig 1.2.1a] Anatomic specimen of the extended knee after the lateral capsule and the complete iliotibial band has been removed.

19. 1.2 – Lateral aspect of the knee The deep and middle lateral layer
[Fig 1.2.1b] Anatomic specimen of the flexed knee after the lateral capsule and the complete iliotibial band have been removed.

20. 1.2 – Lateral aspect of the knee The deep and middle lateral layer
[Fig 1.2.1b] Anatomic specimen of the flexed knee after the lateral capsule and the complete iliotibial band have been removed.

21. 1.2 – Lateral aspect of the knee The superficial lateral layer
[Fig 1.2.2] Anatomic specimen of the lateral aspect. The ventral fibers of the iliotibial band attaching to the patella are lifted by a retractor.

22. 1.2 – Lateral aspect of the knee The superficial lateral layer
[Fig 1.2.2] Anatomic specimen of the lateral aspect. The ventral fibers of the iliotibial band attaching to the patella are lifted by a retractor.

23. 1.3 – Posterior aspect of the knee The posterior cruciate ligament
[Fig 1.3.1a] Anatomic specimen: anterior view after resection of the anterior cruciate ligament. The origin of the PCL is on the lateral surface of the medial femoral condyle.

24. 1.3 – Posterior aspect of the knee The posterior cruciate ligament
[Fig 1.3.1a] Anatomic specimen: anterior view after resection of the anterior cruciate ligament. The origin of the PCL is on the lateral surface of the medial femoral condyle.

25. 1.3 – Posterior aspect of the knee The posterior cruciate ligament
[Fig 1.3.1b] Posterior cruciate ligament. The anterior fibers are loose in extension and tight in flexion. The posterior fibers are tight in (hyper-) extension and become loose in flexion.

26. 1.3 – Posterior aspect of the knee The posterior cruciate ligament
[Fig 1.3.1b] Posterior cruciate ligament. The anterior fibers are loose in extension and tight in flexion. The posterior fibers are tight in (hyper-) extension and become loose in flexion.

27. 1.3 – Posterior aspect of the knee The posterior cruciate ligament
[Fig 1.3.1b] Posterior cruciate ligament. The anterior fibers are loose in extension and tight in flexion. The posterior fibers are tight in (hyper-) extension and become loose in flexion.