Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration: A Review

Abstract

Mucoid degeneration and ganglion cyst are two distinct non-traumatic lesions of the anterior cruciate ligament (ACL) that most commonly occur discretely but occasionally coexist. They are relatively uncommon, and their exact aetiopathogenesis is still not clear. ACL ganglion cyst occurs more frequently among relatively younger patients compared to mucoid degeneration. They could be asymptomatic and discovered incidentally while evaluating the knee for other pathologies. Symptomatic cases of the two conditions present with nonspecific chronic pain, painful limitation of terminal flexion and extension, and mechanical block (among other symptoms), similar to that of other internal derangement pathologies of the knee. Magnetic resonance imaging is the investigation of choice, and diagnostic criteria are defined. Arthroscopic management of these conditions efficiently provides an improvement in symptoms without instability. Computed tomography scan guided aspiration is also useful in selected cases of ACL ganglion cyst. ACL ganglion cyst and mucoid degeneration should be considered in the differential diagnosis of chronic knee pain and stiffness of unspecified etiology.

Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament

“… 1 2 4 5 7 9 10 11 12 13 14 15 16 17 19 20) As noted in previous reports, clinical symptoms of MD of the ACL include nonspecific knee pain with limitation of the range movement and ligament stability. 7 9 18 19 20) None of our patients knew precisely when their symptoms started, but all had persistent knee pain in terminal flexion for at least 12 months, which was distinct from acute extension pain caused by meniscus bucket-handle tears. The fact that our patients did not have a trauma prior to the onset of knee pain and their symptoms did not respond to nonsteroidal anti-inflammatory drugs and physiotherapy helped us to suspect MD of the ACL.…”

“…Both lesions of ACL are two different entities that occasionally coexist. 18) The aim of this study was to detail the clinical, radiological, arthroscopic and pathological findings of this condition and report the clinical outcomes following arthroscopic treatment of MD of the ACL.…”

“… 6 19) Nowadays, although we performed 18 complete ACL resections and obtained good results, we agree with the current literature that recommends debulking of the lesion without compromising the integrity of the ACL. 18) …”

Clinical and radiological comparison between partial and complete resection of the anterior cruciate ligament in patients with mucoid degeneration of the anterior cruciate ligament: a controlled clinical trial

“…MDACL was subject of many clinical cases and short heterogeneous series [1][2][3][7][8][9][10][11][12][13][14][15][16][17][18]. All previous studies confirmed that clinical symptoms of MDACL include mostly posterior knee pain with limitation of the range movement and sometimes deteriorated ligament stability [10,11,[17][18][19]. Moreover, most patients did not have a trauma prior to the onset of knee pain and their symptoms did not respond to nonsteroidal anti-inflammatory drugs and physiotherapy.…”

Clinical Outcomes of Arthroscopic Notchplasty and Partial Resection for Mucoid Degeneration of the Anterior Cruciate Ligament

“…Many of these ganglion cysts were found incidentally without symptoms and often coexisted with MD-ACL. Although the pathogenesis of ACL ganglion cysts remains controversial [ 23 , 25 , 26 ], in our opinion, there are similarities to those of MD-ACL, including trauma theories. Krudwig et al [ 9 ] reported that symptoms, such as pain and limited ROM, were found in only 11% of their cases, and that these symptoms were related to the size and location of the ganglion cysts [ 25 ].…”