Mucoid degeneration of the anterior cruciate ligament: a case report

Kadi, Khalid Ibn El; Marcaillou, Florian; Blanc, Stéphane; Salloum, Bassam; Dimontagliari, Cyril

doi:10.11604/pamj.2013.15.59.2534

Cited by 2 publications

(2 citation statements)

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“…A review of the literature on the subject reveals many clinical cases and short heterogeneous series ( Table 4 ). 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.…”

Section: Discussionmentioning

confidence: 66%

“…Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. 1 2 7 8 9 10 11 12 13 14 15 16 17) 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. Based on previous reports in the literature, our hypothesis was that partial or total ACL resection would improve pain, symptoms, and range motion at the expense of residual anterior laxity that would not necessitate additional treatment.…”

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confidence: 99%

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

et al. 2018

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BackgroundMucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment.MethodsA historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. The minimum follow-up was 3 years. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period.ResultsSeventeen females (67%) and eight males (33%) were included in the final analysis. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. No reconstruction was performed at the same time. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01).ConclusionsOur study provides further evidence that arthroscopic total or partial excision of anterior cruciate ligament is a safe and effective treatment for mucoid degeneration of the anterior cruciate ligament, improving patient satisfaction and function without causing clinical instability in daily activities. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary.

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Section: Discussionmentioning

confidence: 66%

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confidence: 99%

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

et al. 2018

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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

Oehler

Haenle

Vogt

et al. 2022

Arch Orthop Trauma Surg

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Introduction The pathology of a mucoid degeneration of the anterior cruciate ligament (MDACL) has been mentioned in several publications but due to its rare incidence it is not a well-known pathology. Partial or complete resection of the ACL is the option of choice after failed non-surgical treatment. However, the success rate of both surgical techniques and the subsequent risk of an ACL instability is not known. The purpose of this study was to compare the clinical and radiological outcome between partial resection and complete resection of the ACL in patients with MDACL. Materials and methods Patients with MDACL verified by MRI and persistent knee pain were treated by partial (Group I) or complete resection (Group II) of the ACL and were included in a controlled clinical trial after unsuccessful conservative treatment for at least 6 months. Demographic, clinical and radiological data including the thickness of ACL, ACL/intercondylar ratio, patient’s age at the time of surgery, the presenting symptoms, range of motion and ligament stability assessed by the ACL ligament score (Lachman test) were collected. In addition, Tegner activity score and Lysholm score were evaluated preoperatively and at final follow-up after a minimum of 12 months. Results At final follow-up with a mean of 16.8 ± 8.8 months (range 12–41; Group I: 18.3 ± 9.7 vs. Group II: 15.3 ± 8.0; ns), all patients were pain free. Postoperatively, positive Lachman tests were noted in all patients (100%) in Group II (n = 5 patients with grade II and n = 5 patients with grade III). In Group I, 8 patients (80%) showed a negative Lachman test (grade I) and 2 patients (20%) a slightly elongated Lachman test with a firm stop (grade II). The mean knee flexion at follow-up examination was 132° ± 7° (range 120°–140°; Group I: 129° ± 9° vs. Group II: 135° ± 4°; ns). In pairwise comparison, flexion angle increased significantly in both groups (Group I: p = 0.0124 and Group II: p < 0.001). Pairwise comparison of thickness of the ACL and ACL/intercondylar ratio prior to and post-surgery in Group I showed non-significant differences. Conclusion Both arthroscopic debridement and complete resection of the ACL lead to improvement of clinical and radiological findings in isolated MDACL. However, complete resection of the ACL will result in higher instability. Therefore, partial resection might be the better treatment option, especially in young patients with MDACL.

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Mucoid degeneration of the anterior cruciate ligament: a case report

Cited by 2 publications

References 14 publications

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

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

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

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