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September 27, 1965

Internal Derangement of the Knee

Author Affiliations

From the Fracture Clinic, Massachusetts General Hospital, Boston.

JAMA. 1965;193(13):1116-1117. doi:10.1001/jama.1965.03090130044014

Dr. Kirby vonKessler: A 21-year-old man was in an accident while riding a motor bicycle. He entered an emergency ward at a nearby hospital, with multiple abrasions about his left knee. The knee was diffusely swollen and tender. X-ray films were interpreted as normal. After the abrasions were thoroughly cleansed and wrapped in sterile bandages, the patient was discharged using crutches.

A loose body measuring approximately 2 cm in diameter was noted in the anterior portion of the joint space of the knee when a radiologist interpreted the x-ray films 72 hours later. The patient was then referred to the Massachusetts General Hospital. Because of this lapse of time, the abrasions were grossly infected. The patient could flex the knee to 70°, but was unable to extend it beyond 45° from full extension. A positive "anterior drawer sign" was present. Because the knee could not be fully extended, the stability