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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2011

01-08-2011 | Knee

Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines

Authors: Francois Lintz, Nicolas Pujol, Philippe Boisrenoult, Kevin Bargoin, Philippe Beaufils, David Dejour

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2011

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Abstract

Purpose

Anterior cruciate ligament (ACL) mucoid degeneration is a rare encounter in clinical practice, different, but often confused with ACL mucoid cysts. Its pathophysiology remains unclear. However, recent publications have suggested that it might be underdiagnosed or misdiagnosed, and that the adverse effects of treatment by ACL resection might be underestimated. The object of this work was to summarize this scattered knowledge to improve patient management.

Methods

The authors carried out an exhaustive and comprehensive review of up-to-date literature. An extensive search of the MEDLINE database was carried out using MESH terms (ganglion cyst, anterior cruciate ligament) and generic search terms (mucoid degeneration, hypertrophy).

Results

Anterior cruciate ligament mucoid degeneration is determined by interstitial glycosaminoglycan deposits amidst the collagen bundles causing ACL hypertrophy, knee pain, and limited range of motion. It is thought to arise from a primary synovial lesion and is associated with arthritic change or subsequent to acute or repeated trauma. Diagnosis is made on MRI scans and confirmed on histopathological samples. Current treatment involving ACL arthroscopic resection is efficient on pain and range of motion but is not a benign procedure and causes knee laxity.

Conclusions

Anterior cruciate ligament mucoid degeneration needs to be more broadly known and properly diagnosed so that progress can be made in its management. Further research will be necessary to confirm the current trends in the literature, which suggest being less aggressive with ACL arthroscopic resection when dealing with mucoid degeneration and making more use of conservative measures such as notchplasty.

Level of evidence

Systematic review, Level IV.
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Metadata
Title
Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines
Authors
Francois Lintz
Nicolas Pujol
Philippe Boisrenoult
Kevin Bargoin
Philippe Beaufils
David Dejour
Publication date
01-08-2011
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1433-0

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