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

Ventura, Diego; Núñez, Jorge H.; Jubert, Nayana Joshi; Castellet, Enric; Minguell, Joan

doi:10.4055/cios.2018.10.3.307

Cited by 18 publications

(28 citation statements)

References 23 publications

(57 reference statements)

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“…Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [ 14 , 16 , 17 ]. The reported restriction of range of movement was flexion deficit in four studies [ 3 , 13 , 15 , 17 ], extension deficit in one study [ 14 ] and combined flexion and extension deficit in four studies [ 6 , 16 , 18 , 19 ] (Table 4 ).…”

Section: Resultsmentioning

confidence: 99%

Management of mucoid degeneration of the anterior cruciate ligament: a systematic review

Sweed

Mussa

El‐Bakoury

et al. 2021

Knee Surg & Relat Res

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Purpose The purpose of this study was to investigate the outcomes of management of mucoid degeneration of the anterior cruciate ligament (MDACL) by performing a systematic review of methods of treatment that have been reported. Methods A systematic literature search in the databases MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus was performed through July 2020 by three independent reviewers. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42018087782). Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Results A total of nine studies were eligible for review. All nine studies assessed the outcome of arthroscopic debridement of MDACL. A total of 313 knees in 292 patients were included. The mean follow up ranged from 13 to 72 months. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). The rate of simultaneous meniscectomy ranged from 13 to 44%. Postoperative pain relief ranged from 53.8 to 95%. There was an improvement in postoperative range of motion and outcome scores (Lysholm and International Knee Documentation Committee scores and the Knee Injury and Osteoarthritis Outcome Score). Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. The mean MINORS score was 9.5 out of 16 (4–12). Conclusions Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Level of evidence IV

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Section: Resultsmentioning

confidence: 99%

Management of mucoid degeneration of the anterior cruciate ligament: a systematic review

Sweed

Mussa

El‐Bakoury

et al. 2021

Knee Surg & Relat Res

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“…However, two patients underwent subsequent ACL reconstruction. Ventura et al treated their patients with partial resection of the ACL in 8 (32%) knees and total resection in 17 (68%) without notchplasty [ 15 ]. They reported a negative pivot shift test and a positive Lachman test for all patients, and reconstruction of the ACL was performed in one young patient.…”

Section: Discussionmentioning

confidence: 99%

“…Trauma-based theories have addressed the relationship between the anatomy of the intercondylar notch and MD-ACL [ 6 ], and the impingement of a hypertrophied ACL on a narrow intercondylar notch has been proposed as one possible cause [ 6 , 12 , 13 ]. In this regard, previous reports have suggested arthroscopic resection of a hypertrophied ACL as a treatment method, including a consensus on arthroscopic resection for MD-ACL resulting in good clinical outcomes, including pain relief and ROM recovery [ 4 , 6 , 10 , 14 , 15 ]. However, there is a lack of literature that has focused on the resected volume of the ACL, nor is there a consensus regarding how much of the ACL should be removed.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is a lack of literature that has focused on the resected volume of the ACL, nor is there a consensus regarding how much of the ACL should be removed. Furthermore, whether to undergo an additional notchplasty still remains controversial [ 4 , 6 , 14 , 15 , 16 ]. We hypothesized that additional notchplasty could be an alternative procedure to avoid total resection of the ACL and postoperative instability [ 5 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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

Lee

Ahn

Gwak

et al. 2021

JCM

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Background: Mucoid degeneration of the anterior cruciate ligament (MD-ACL) is a chronic degenerative process involving a hypertrophied ACL, which may lead to notch impingement syndrome. As a treatment method, there is consensus regarding arthroscopic resection for MD-ACL resulting in good clinical outcomes; however, additional notchplasty remains controversial. The purpose of this study was to investigate clinical outcomes after arthroscopic partial resection of the ACL and additional notchplasty performed to minimize volume reduction of the ACL. Study Design: Level IIIb retrospective cohort study. Methods: Of 1810 individuals who underwent knee arthroscopic surgery performed by the same surgeon between July 2011 and October 2020, 52 were included, while 10 were excluded due to a follow-up period of <1 year. Clinical data including pain location, terminal flexion or extension pain, range of motion (ROM), Lysholm knee score, and Hospital for Special Surgery (HSS) knee score were assessed pre- and postoperatively. Additionally, according to the resected volume of the ACL, patients were classified into two groups: <25% (Group 1), and 25–50% (Group 2). Clinical outcomes were compared between the two groups. Results: There were 17 (40.5%) men and 25 (59.5%) women with a mean age of 53.9 years (range, 16–81 years) at the time of surgery. The mean duration of symptoms before surgery was 14.4 months (range, 3–66 months). Arthroscopic partial resection of the MD-ACL was performed in all patients, and concomitant notchplasty was performed in 36 (81.8%). All clinical scores improved postoperatively, and were statistically significant (p < 0.01). However, there was no significant difference in clinical outcomes between groups 1 and 2 classified according to the resected ACL volume. Recurrence of MD-ACL was recorded in only one patient, 11 months after arthroscopic treatment. No patients underwent ACL reconstruction because of symptoms of anterior instability. Conclusion: Arthroscopic partial resection of the ACL and concomitant notchplasty yielded satisfactory outcomes for the treatment of MD-ACL. Notchplasty may be an alternative procedure to avoid total ACL resection and postoperative instability.

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“…Im Kontext der Literatur finden sich bislang jedoch keinerlei Hinweise auf durch Ganglien oder Zysten verursachte, höhergradige Schäden, wie z. B. Instabilitäten eines Gelenks und hier speziell des Kniegelenks [1,7,9,12]. Intra-oder periartikuläre Zysten des Kniegelenks sind oftmals Zufallsbefunde, die, sofern sie keine Beschwerden bereiten, nicht zwingend therapiert werden müssen [9,13].…”

Section: Diskussionunclassified

Atraumatische Instabilität des vorderen Kreuzbandes durch eine intraligamentäre Zyste

Burchard

Graw

2020

Sportverletz Sportschaden

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ZusammenfassungEin 28-jähriger Mann wurde mit einem Instabilitätsgefühl im Knie beim Fußballspielen ohne vorhergehendes Unfallereignis vorstellig. Die klinische Untersuchung ergab sowohl einen pathologischen Lachmann- als auch einen pathologischen Pivot-Shift-Test. Die kernspintomografische Bildgebung zeigte eine intraligamentäre Zyste des vorderen Kreuzbandes (VKB). In der darauffolgenden Arthroskopie zeigte sich eine durch die Zyste verursachte subtotale Zerstörung des VKB. Nach einer VKB-Ersatzplastik mittels Semitendinosustransplantats war das Gelenk wieder stabil. Gelenkzysten sind selten und verursachen häufig unspezifische Schmerzen oder Bewegungseinschränkungen. Bislang wurden keine Zusammenhänge zwischen intraligamentären Zysten und einer Gelenkinstabilität beschrieben. Eine mögliche präventive Resektion auch asymptomatischer und zufällig gefundener Ligament-assoziierter Zysten ist zu diskutieren.

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

Cited by 18 publications

References 23 publications

Management of mucoid degeneration of the anterior cruciate ligament: a systematic review

Management of mucoid degeneration of the anterior cruciate ligament: a systematic review

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

Atraumatische Instabilität des vorderen Kreuzbandes durch eine intraligamentäre Zyste

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