ce of surgeons
varies regarding the nature of the laceration. In our experience the
most common form is a longitudinal split, whereby a portion of the
inner edge of the cartilage is separated from the rest and projects as
a tag towards the centre of the joint (Fig. 86). As a rule, it is the
anterior end that is torn, less frequently the posterior end.
Sometimes the meniscus is split from end to end, the outer crescent
remaining in position, while the inner crescent passes in between the
condyles and lies curled up against the cruciate ligaments.
Occasionally the anterior end is torn from its attachment to the
tibia, less frequently the posterior end. In one case we found the
meniscus separated at both ends and lying between the bones and the
capsule.

The _clinical features_ are similar to those of mobile meniscus with
displacement, and as a rule the exact nature of the lesion is only
discovered after opening the joint.

The _treatment_ consists in excising the loose tag or the whole
meniscus, according to circumstances. The recovery of function is
usually complete. It is not advisable to attempt to stitch the torn
portion in position.

#Rupture of the Cruciate Ligaments.#--A few cases have been recorded
in which, as a result of severe twisting forms of violence, the
cruciate ligaments have been torn from their attachments, leaving the
joint loose and unstable, so that the tibia and the femur could be
moved from side to side on one another. When the disability persists,
the joint may be opened and the ligaments sutured in position (Mayo
Robson).

#Sprains# of the knee are comparatively common as a result of sudden
twisting or wrenching of the joint. In addition to the stretching or
tearing of ligaments, there is usually a considerable effusion of
fluid into the synovial cavity, and examination with the X-rays
occasionally reveals that a portion of bone has been torn away with
the ligament--_sprain-fracture_. The swelling fills up the hollows on
either side of the patella, and extends for some distance in the
synovial pouch underneath the quadriceps. The patella is raised from
the front of the femur by the collection of fluid in the
joint--"floating patella"--and, if firmly pressed upon, it may be made
to rap against the trochlear surface.

A sprain is to be diagnosed from separation of one or other of the
adjacent epiphyses, fracture involving the articular ends of the
bones, and displacement of the semilunar me