Research Article| Volume 17, ISSUE 4, P256-258, July 1986

The locked knee

  • R.L. Allum
    Requests for reprints should be addressed to: Mr R. L. Allum, Consultant Orthopaedic Surgeon, Wexham Park Hospital, Slough, Berkshire SL2 4HL.
    Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex U.K.
    Search for articles by this author
  • J.R. Jones
    Northwick Park Hospital and Clinical Research Centre, Harrow, Middlesex U.K.
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      Fifty patients presenting themselves with a locked knee were investigated prospectively by examination under anaesthesia and arthroscopy. Definite abnormality was found in 92 per cent. Torn menisci were present in 68 per cent and isolated ruptures of the cruciate ligament in 10 per cent. Loose bodies were found in 3 patients, degenerative changes alone in 2 patients and a pathological medial synovial shelf in 1 patient. No abnormality was demonstrated in 8 per cent. Sixteen per cent of the knees remained locked following the induction of anaesthesia.
      This study demonstrates that a true mechanical block is not necessarily present and that the position of an unstable meniscal fragment is not consistently related to the fixed position of the knee under anaesthetic. There were no clinical features that allowed the normal knees to be distinguished preoperatively from those with internal derangement. It is proposed that these patients should be managed by prompt examination under anaesthesia, arthroscopy and definitive surgery.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Injury
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Apley A.G.
        5th ed. A System of Orthopaedics and Fractures. Butterworths, London and Boston1977
      1. 7th ed. Concise Oxford English Dictionary. Oxford University Press, Oxford1982
        • Critchley I.J.
        • Bracey D.J.
        The acutely locked knee—is manipulation worthwhile?.
        Injury. 1985; 16: 281
        • Dandy D.J.
        Arthroscopic Surgery of the Knee. Churchill Livingstone, London and Edinburgh1981
        • Farquharson-Roberts M.A.
        • Osborne A.H.
        Partial rupture of the anterior cruciate ligament of the knee.
        J. Bone Joint Surg. 1983; 65B: 32
      2. Jackson J.P. Waugh W. Surgery of the Knee Joint. Chapman and Hall, London1984
        • McDaniel W.J.
        Isolated partial tear of the anterior cruciate ligament.
        Clin. Orthop. 1976; 115: 209
        • McMaster J.
        • Weindert C.R.
        • Scranton D.
        Diagnosis and management of isolated anterior cruciate ligament tears.
        J. Trauma. 1974; 14: 230
        • Marcus R.E.
        • Albers W.E.
        • Thompson G.H.
        Extruded osteochondral nail: an interesting cause of knee locking.
        Clin. Orthop. 1981; 157: 161
        • Monaco B.R.
        • Noble H.B.
        • Bachman D.C.
        Incomplete tears of the anterior cruciate ligament and knee locking.
        JAMA. 1982; 247: 1582
        • Noyes F.R.
        • Bassett R.W.
        • Grood E.S.
        • et al.
        Arthroscopy in acute traumatic haemarthrosis of the knee.
        J. Bone Joint Surg. 1980; 62A: 687
        • Shakespeare D.T.
        • Rigby H.S.
        The bucket-handle tear of the meniscus.
        J. Bone Joint Surg. 1983; 65B: 383
        • Smillie I.S.
        5th ed. Injuries of the Knee Joint. Churchill Livingstone, Edinburgh, London and New York1978
        • Testa N.N.
        • Williams L.A.
        • Klein M.J.
        An unusual cause of knee locking.
        Clin. Orthop. 1978; 134: 174