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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

15-06-2023 | Wound Debridement | KNEE

Partial debridement is the most commonly reported treatment option for mucoid degeneration of the anterior cruciate ligament: a systematic review

Authors: Prushoth Vivekanantha, Yi David Diao, Jeffrey Kay, Yuichi Hoshino, Kanto Nagai, Darren de SA

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2023

Abstract

Purpose

To determine clinical outcomes and risks of various management strategies for mucoid degeneration of the anterior cruciate ligament (MD-ACL).

Methods

Three databases MEDLINE, PubMed and EMBASE were searched from inception to January 29th, 2023 for literature outlining clinical outcomes for various management strategies of MD-ACL. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on satisfaction scores, visual analogue scale (VAS) scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, Knee Osteoarthritis and Outcome Scores (KOOS), range of motion and Lachman test were recorded.

Results

A total of 14 studies comprising 776 patients (782 knees) were included in this review. Partial debridement was reported in ten (71.4%) studies comprising 446 patients, showing significant improvements in VAS, Lysholm, IKDC scores and range of motion. Complete debridement was reported by two (14.2%) studies comprising 250 patients, and resulted in increases in Lysholm scores, KOOS, and range of motion. Reduction plasty was reported in two (14.2%) studies comprising 26 patients and showed improvements in VAS and Lysholm scores, and range of motion. Other methods of treatment included conservative management and ultrasound decompression. Complete debridement resulted in 10/23 (43%) patients with a positive Lachman test. This was followed by reduction plasty and partial debridement, with 5/26 (19.2%) and 45/340 (13.2%) patients respectively having positive Lachman or elevated knee arthrometer scores. Pivot shifting was only reported in studies on partial debridement and reduction plasty, with 14/93 (15.1%) and 1/21 (4.8%) patients have positive results, respectively.

Conclusion

The most commonly reported management strategy for MD-ACL is partial debridement with complete debridement, reduction plasty and conservative management as alternative options. Current operative management strategies place individuals at risk for ACL insufficiency. Information from this review can aid surgeons and clinicians in understanding what treatment options are best for this patient population, by understanding the reported clinical benefits and risks of each strategy.

Level of evidence

IV.

Available only for authorised users

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Title: Partial debridement is the most commonly reported treatment option for mucoid degeneration of the anterior cruciate ligament: a systematic review
Authors: Prushoth Vivekanantha
Yi David Diao
Jeffrey Kay
Yuichi Hoshino
Kanto Nagai
Darren de SA
Publication date: 15-06-2023
Publisher: Springer Berlin Heidelberg
Keyword: Wound Debridement
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2023
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-023-07479-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Partial debridement is the most commonly reported treatment option for mucoid degeneration of the anterior cruciate ligament: a systematic review

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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