The subject of the present report entered St. Mary's General Hospital on October 24, 1885, with the following history: About twenty years ago she fell and suffered a transverse fracture of the patella. The fracture was treated in the ordinary way, and in due course of time union by ligament resulted, with a distance of about two inches between the fragments. Three days prior to her admission to the hospital, she again fell and ruptured the ligamentous connecting band between the fragments, at the same time breaking up a partial anchylosis of the knee-joint of a fibrous character, which had existed ever since the first accident, twenty years ago.
At the time of her admission, there existed some synovitis and considerable effusion in the knee-joint, the result of the recent injury. When this had subsided it was decided to open the knee-joint, remove the fibrous connecting band, and, after freshening