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In the Western world we live in a society obsessed by sport. At recreational level, this allows an escape from the pressures of modern life, and, at the elite level, sport is now an established part of the entertainment industry, with enormous material rewards for the participants. At all levels, injury is a constant threat, and, of all injuries, those of the knee fulfil the athlete's greatest fear of spending a long time out of action. This is confirmed by a study from Sheffield, which showed the knee to have been the most commonly injured joint and soccer and rugby to have the highest risks.1 It has been said of our national game that it is not so much a sport as a knee disease!
Not only may a knee injury require surgery followed by months of rehabilitation, but permanent disability from both sport and work may be the outcome. Indeed, a large study from Scandinavia found that the most common cause of permanent disability following a sports injury was injury to the knee.2
There is little work on the pattern of knee injuries in the United Kingdom, although a multicentre study is currently in progress. The work that has been carried out abroad, however, has produced some interesting information. It is not widely appreciated that ligament damage to the knee is more common than any other type of knee injury pathology (fig 1).3 Many medical students, general practitioners, and paramedics may be familiar with the story of a weight bearing, twisting injury producing a meniscal tear; however, there is generally a profound ignorance about the history and signs of the more common (and potentially more devastating) ligament …