Mucoid degeneration of the posterior cruciate ligament: a case report

Shoji, Takeshi; Fujimoto, Eisaku; Sasashige, Yoshiaki

doi:10.1007/s00167-009-0885-y

Cited by 14 publications

(23 citation statements)

References 14 publications

(26 reference statements)

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“…39 Specific histological changes in the PCL and the ACL When the ACL and PCL ligament scores were compared in a pairwise fashion, ACL inflammation scores were found to be significantly higher than the corresponding PCL scores (t 116 =3.63, p<0.001), and PCL chondroid metaplasia scores were significantly greater than their ACL counterparts (t 115 =−2.71, p=0.009). No significant pairwise differences between ACL and PCL scores were found with inflammation, mucoid degeneration, fibre organisation, or total scores.…”

Section: Pcl Acl and Cartilage Changesmentioning

confidence: 98%

“…38 While clinically symptomatic, mucoid degeneration is a rare condition. 39 It has previously been described histologically in patients undergoing knee arthroplasty, 13 40 and been visualised by MRI in a small number of cases. 41 Based on the present findings, mucoid degeneration appears to develop gradually, first appearing in the fifth decade, with minimal increase in severity thereafter.…”

Section: Histological Changes In Pcl Versus Aclmentioning

confidence: 99%

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Histopathological changes in the human posterior cruciate ligament during aging and osteoarthritis: correlations with anterior cruciate ligament and cartilage changes

et al. 2012

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Objectives-To determine the histological patterns of posterior cruciate ligament (PCL) degeneration during aging and in relation to changes in articular cartilage and anterior cruciate ligament (ACL) across the entire adult age spectrum.Methods-Human knee joints (n=120 from 65 donors) were processed within 72 hours postmortem. Articular cartilage surfaces were graded macroscopically. Each PCL was histologically evaluated for inflammation, mucinous changes, chondroid metaplasia, cystic changes and orientation of collagen fibers. Severity of PCL degeneration was classified as normal, mild, moderate or severe. PCL scores were compared to ACL and cartilage scores from the same knees.Results-All knees had intact PCL. Histologically, 6% were normal, 76% showed mild, 12% moderate and 9% severe degeneration. Fiber disorientation was the most prevalent and severe change. Histological grades of PCL and ACL correlated but significantly fewer PCL than ACL showed severe changes. There was weaker correlation between aging and total histological PCL scores (R=0.26) compared to aging and ACL scores (R=0.42). ACL scores correlated with cartilage scores (R=0.54) while PCL scores increased with severity of OA from grades 0 to III but not between OA grades III to IV (R=0.32). In knees with ruptured ACL, the PCL scores correlated with cartilage scores of the lateral compartment.Conclusions-PCL histopathological changes are less severe than in the ACL. PCL degeneration was associated with ACL and cartilage damage. The lack of correlation with age indicates independent pathways for PCL versus ACL degeneration.

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Section: Pcl Acl and Cartilage Changesmentioning

confidence: 98%

Section: Histological Changes In Pcl Versus Aclmentioning

confidence: 99%

Histopathological changes in the human posterior cruciate ligament during aging and osteoarthritis: correlations with anterior cruciate ligament and cartilage changes

et al. 2012

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“…Second, in this previous study only the ''tram-track appearance'' was considered as imaging criterion of PCL mucoid degeneration, although PCL thickening was also described in association with such intra-ligamentous signal intensity change. In the present study, the imaging criteria of mucoid degeneration of the PCL included both intra-ligamentous signal abnormalities resembling a ''tram track'' and thickening in PCL antero-posterior diameter, either partial or diffuse, which was further described in previous case reports (1)(2)(3). Importantly, three-plane evaluation allowed us to distinguish the meniscofemoral ligaments, which are adjacent to the PCL and may be erroneously interpreted as part of its peripheral rim in only one plane.…”

Section: Discussionmentioning

confidence: 70%

Magnetic resonance imaging of degenerative changes of the posterior cruciate ligament

et al. 2016

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Background Mucoid degeneration and ganglia reflect a continuum of degenerative changes within the posterior cruciate ligament (PCL). Purpose To assess the prevalence of and radiologists' familiarity with PCL mucoid degeneration and ganglia. Material and Methods Knee magnetic resonance imaging (MRI) from July 2013 to June 2015, excluding patients who had a preceding trauma or MRI findings indicative of a prior injury, were retrospectively reviewed, with the specific request to assess degenerative changes of the PCL, by the same musculoskeletal radiologists who previously reported these examinations, and one fellow. Results A total of 692 patients entered this study. The radiologists and the fellow together identified mucoid degeneration in 34 patients (4.9%), ganglia in 14 patients (2.0%), and both in four patients (0.6%). Several patterns of PCL mucoid degeneration were identified: diffuse thickening in seven patients, partial thickening in 16 (four associated with a ganglion), longitudinal intraligamentous PCL signal-intensity abnormalities resembling a "tram track" in 15. In all cases there was increased signal intensity on fluid-sensitive sequences. In the previous reports, only three cases of PCL mucoid degeneration out of 38 (7.9%) were described, with intraligamentous PCL signal-intensity abnormalities. In the reports of the patients with degeneration and ganglia, only ganglia were described. In the previous reports, ganglia were correctly diagnosed. Conclusion Mucoid degeneration of the PCL is much more common than previously assumed and is underestimated by radiologists.

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“…No ligament antero-posterior instability of the knee was identified by the Lachman, and anterior/posterior drawer tests. Plain radiograph showed medial OA Kellgren-Lawrence grade 3, 8 , 9 but no rapid progression in comparison with three months earlier. MRI demonstrated intermediate signal in T1-weighted and increased signal in T2-weighted images diffuse within the ACL so-called “celery stalk” sign, 8 , 9 but no typical mucoid change within the PCL ( Fig.…”

Section: Case Presentationmentioning

confidence: 73%

“… 7 However, it has been unknown what the microscopic condition of the PCL may be in mucoid degeneration of the ACL. Identically, we have a few reports about the mucoid degeneration of PCL 8 , 9 , but it has been unknown what the microscopic condition of the ACL, because they didn't have a histologic evaluation. We couldn't find any previous reports on mucoid degeneration of both cruciate ligaments macroscopically or microscopically.…”

Section: Introductionmentioning

confidence: 99%

Mucoid degeneration of the cruciate ligaments in osteoarthritis under primary total knee arthroplasty

Kawaguchi

Michishita

Manabe

et al. 2018

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilit

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Mucoid degeneration of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) with osteoarthritis is rarely reported. We experienced two knee osteoarthritic patients who had symptomatic mucoid degeneration of their ACL, and their PCL was also diagnosed as mucoid degeneration in histological evaluation. Preoperative radiological evaluation could not reveal precisely whether the degeneration had extended to the PCL. We obtained good clinical results treating them with posterior-stabilized (PS) total knee arthroplasty (TKA) sacrificing both ligaments. In cases of osteoarthritis with mucoid degenerated ACL, PS TKA should be considered, sacrificing both cruciate ligaments, because mucoid degeneration might expand both cruciate ligaments.

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Mucoid degeneration of the posterior cruciate ligament: a case report

Cited by 14 publications

References 14 publications

Histopathological changes in the human posterior cruciate ligament during aging and osteoarthritis: correlations with anterior cruciate ligament and cartilage changes

Histopathological changes in the human posterior cruciate ligament during aging and osteoarthritis: correlations with anterior cruciate ligament and cartilage changes

Magnetic resonance imaging of degenerative changes of the posterior cruciate ligament

Mucoid degeneration of the cruciate ligaments in osteoarthritis under primary total knee arthroplasty

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