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Figure 2 Premature osteoarthritis after anterior cruciate ligament (ACL) injury. Radiographs of a 40 year old man who had sustained an ACL rupture 20 years earlier. Note the joint space narrowing and osteophyte formation consistent with premature osteoarthritis (arrow) on the medial aspect of the left knee (knee with ACL tear) and the preservation of medial joint space in the knee with the intact ACL on the right (arrow). (Myrray, MM 2009)