Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: Clinical and knee laxity outcomes in 23 cases

Morice, Antoine H.P.; Coupry, Augustin; Lintz, François; Robert, H.

doi:10.1016/j.otsr.2013.04.010

Cited by 26 publications

(34 citation statements)

References 15 publications

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“…4,22 In the present series, the postoperative outcomes demonstrate that partial ACL debridement (radio frequency debulking) for MD-ACL can lead to complete resolution of symptoms, full range of movement, and improvement in quality of life. Morice et al demonstrated that in a 23 patients series who all underwent partial ACL debridement, 20% resulted in an unstable knee, 6 which was similar to that of our study. Patients should be made aware that this is a complication of the surgery and that it is related to the amount of ACL tissue that is debrided.…”

Section: Discussionsupporting

confidence: 91%

“…However, due to limited recognition, study numbers are small and the optimum management strategy is yet to be elucidated. 5,6 This case series presents 31 cases of MD-ACL, characterizing the clinical presentation, examination findings, and radiological features. It is the first report within the literature that describes the natural history and compares this to arthroscopic ACL debridement using validated knee scores.…”

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confidence: 99%

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Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures

et al. 2018

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The presentation and clinical course of mucoid degeneration of the anterior cruciate ligament (MD-ACL) are poorly documented within the literature. Subsequently, it is under-diagnosed and the optimal management strategy remains ill-defined. Here, we characterize the syndrome associated with MD-ACL and compare the natural clinical course with the outcomes of arthroscopic management. Thirty-one patients with radiological features of MD-ACL over a 2-year period had their clinical notes retrospectively reviewed. Seven patients underwent arthroscopic debridement of the ACL for MD. These were followed up for a minimum of 2 years and an average of 2.8 years from surgery. The remainder were managed conservatively ( = 24) and were followed up for a minimum of 2 years and an average of 4.0 years. The notch width index (NWI) and associated pathology was noted. Primary outcome measures were presence of knee pain and use of analgesia. Secondary outcome measures were the Oxford and Lysholm knee scores. The most commonly reported symptoms were posterior knee pain (77.4%) and limitation of terminal flexion (58.1%). All patients who underwent arthroscopic debridement were pain and analgesia free at follow-up. Of the patients who did not undergo arthroscopic surgery, three patients had knee replacement surgery and three were lost to follow-up. The remaining patients, 14/18 (77.8%), reported knee pain and regular analgesia use at follow-up, which was significantly more than the arthroscopic debridement group ( < 0.01). The knee scores were significantly better in the arthroscopic debridement group at follow-up (Oxford knee score: 45 vs 34; Lysholm: 92 vs 67; < 0.01). Furthermore, the postoperative improvement in the Oxford knee and Lysholm scores compared with preoperatively was 12.1 and 31.8 points, respectively ( < 0.01). The NWI was increased in patients with mild-to-severe osteoarthritis (0.266 vs 0.273; < 0.05). MD-ACL should be considered in patients who report posterior knee pain, limitation of terminal flexion, and it can be associated with other knee pathologies. MD-ACL can be successfully managed with arthroscopic radio frequency debulking with improvement in quality of life at follow-up.

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Section: Discussionsupporting

confidence: 91%

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confidence: 99%

Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures

et al. 2018

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“…A maximum pressure load of 250 N was used in the clinical study of ACL tears and 200 N of pressure load was considered to be the threshold necessary to obtain good reproducibility of measurements in injured knees [6]. Di Iorio et al [8], Lorbach et al [9], and Morice et al [10] applied a maximum pressure load of 134 N while Vauhnik et al [11,12], Beldame et al [13], Jenny and Arndt [14] and Pierrat et al [15] applied a maximum pressure load of 250 N.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of the GNRB® in relation to pressure load for complete ACL tears: A prospective case-control study of 118 subjects

Klouche

Lefèvre

Cascua³

et al. 2015

Orthopaedics & Traumatology: Surgery & Research

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“…Mucoid degeneration of anterior cruciate ligament (ACL) is a benign knee pathology with a frequency of 1.8% to 5.3% [1] [2]. Mucoid degeneration of ACL is well documented, but very little information exists about this clinical entity.…”

Section: Introductionmentioning

confidence: 99%

Mucoid Degeneration of Posterior Cruciate Ligament Leads to Roof Impingement with Anterior Cruciate Ligament: Case Report

Lee¹,

Choi²,

Nam³

et al. 2018

OJO

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Mucoid degeneration of cruciate ligament is rare cause of knee pain, however there are some cases causing pain and restriction of extension. A 60-year-old man came to our clinic complaining of pain in knee joint on full range of extension about 3 months ago. The range of motion (ROM) was a flexion contracture of 5 degree and a further flexion of 140 degree with pain aggravation by forced extension. Magnetic resonance imaging of the knee joint showed thickened posterior cruciate ligament (PCL) mucoid degeneration. Arthroscopic treatment consists of PCL reduction-plasty by debridement of yellowish material in the PCL fiber and reduces the volume of the hypertrophied PCL. Immediately after surgery, patient gain the full ROM without any symptom of impingement. Enlarged PCL can make impingement in femoral notch with anterior cruciate ligament (ACL). Then, Partial debulking surgery of PCL is an effective treatment to pain relief and restore ROM of knee.

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Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: Clinical and knee laxity outcomes in 23 cases

Abstract: Level IV. Retrospective study.

Cited by 26 publications

References 15 publications

Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures

Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures

Diagnostic value of the GNRB® in relation to pressure load for complete ACL tears: A prospective case-control study of 118 subjects

Mucoid Degeneration of Posterior Cruciate Ligament Leads to Roof Impingement with Anterior Cruciate Ligament: Case Report

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