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Novmber 21, 1959


Author Affiliations


Assistant Clinical Professor of Surgery, Harvard Medical School; Surgeon, Peter Bent Brigham Hospital; and Surgeon, Harvard University Health Services.

JAMA. 1959;171(12):1666-1670. doi:10.1001/jama.1959.03010300040010

Prompt, accurate diagnosis and treatment of knee injuries will prevent most of the "trick knees" of middle age. Examination must be thorough, orderly, and complete. Rupture of a ligament should be differentiated from sprain within a few minutes of injury, when diagnostic manipulation can be carried out without pain. Roentgenography is essential, not only to determine fracture or epiphysial injury but also to rule out unsuspected preexisting abnormality of bone. The most frequent injuries encountered are, in descending order of incidence, contusion, ligament sprain, meniscus injury, ligament rupture, and fracture or epiphysial displacement. Most meniscus injuries are accompanied by sprain, which should be allowed to heal before meniscectomy is advised. Immobilization produces muscle atrophy and should be kept to a minimum. Ligament rupture should be repaired promptly. Progressive resistance exercise is essential in convalescence. Protective taping to support the collateral and cruciate ligaments should be worn at each practice session and game for at least a year after any sprain.