She’d come off her new bike
and hurt her knee.
before you see and hurt her knee.
What was the intrepretation of 'she'd' when you (as native English speakers) first read the sentence above?
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Could be either.
This is like asking if "The wood..." is understood to mean "the forest" or the "the timber". It can only be resolved by context. If you explicitly remove that context, it must be ambiguous.
That said, "she had" is more common, so you would probably guess it meant "she had" if you had to bet on it.
Even with the completion, it is still ambiguous: compare
She'd come off her bike and hurt her knee just before the wedding started. (had)
She'd come off her bike and hurt her knee, if she wasn't careful. (would, to form conditional)
She'd come off her bike and hurt her knee every summer. She'd always be covered in scratches and grazes by the time school started in September. (would, for past habit)