What is the normal capsular pattern for the tibiofemoral joint?

• A. Extension > Flexion
• B. Flexion = Extension
• C. Flexion > Extension (5:1)
• D. Abduction and Adduction limited

Answer: (C)

The main idea is how a joint capsule limits motion in a typical pattern when it’s tight. For the tibiofemoral joint (the knee), the capsule tends to restrict bending (flexion) more than straightening (extension). That’s why the normal capsular pattern shows flexion as the more limited movement, with a noticeable difference in how much flexion is lost compared to extension—often described as flexion being restricted about five times more than extension (a 5:1 ratio). In practice, extension stays closer to full range while flexion is significantly reduced.

Abduction and adduction aren’t the primary limits for the knee’s capsular pattern, so those motions wouldn’t characterize the knee’s normal capsular pattern. Similarly, saying flexion equals extension would imply equal loss in both directions, which isn’t typical for the knee.