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you [Music] our case presentation is a 35 year old male otherwise healthy who sustained a left knee injury while snowboarding in Japan approximately one week prior to presentation interestingly the patient developed a DVT and his left gastric knee Mias vein that required IVC filter placement prior to surgery on exam his left knee was noted to have a mild effusion there was no erythema or ecchymosis and the patient was able to straight leg raise he had active range of motion from 0 to 90 degrees as well as a positive anterior and posterior drawer he was noted to have a 2b Lachman and displayed laxity to valgus stress at both 30 degrees and 0 degrees operative radiographs were obtained which demonstrated avulsion fractures of both medial and lateral tibial eminences consistent with cruciate ligament injury MRI imaging was obtained which demonstrated injuries to the anterior cruciate ligament posterior cruciate ligament medial collateral ligament as well as the medial meniscus planned r