2017 ISAKOS Biennial Congress Paper #129

Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament

Jingmin Huang, MD, Tianjin CHINA
Tianjin orthopaedic hospital, Tianjin, CHINA

FDA Status Not Applicable

Summary

Mucoid degeneration of the ACL has a typical clinical feature and the MRI findings are fairly specific for clinical diagnosis before arthroscopy. Arthroscopic debridement of mucoid hypertrophy of the ACL inconjunction with notchplasty can effectively provide symptomatic improvement without instability.

Abstract

Objective

The purpose of this study was to examine the clinical features, radiological and arthroscopic characteristics of mucoid degeneration of the anterior cruciate ligament (ACL) and to assess the results of arthroscopic treatment.

Methods

:From January 2012 to August 2013, 32 knees (24 females and 8 males with left knee of 14 and 18 of right) were diagnosed with mucoid degeneration of the ACL and underwent arthroscopic treatment, all of whom with a mean age of 58.81±7.97 years (42-74 years). All 32 patients have pain on terminal extension, in which 12 patients have pain on both terminal flexion and extension. Arthroscopic debridement of hypertrophied ACL was performed in conjunction with notchplasty. Biopsy specimens were taken from yellowish degenerative lesions of ACL posterolateral bundles. Manual Lachman and Anterior Drawer tests were taken or measured preoperatively, as well as, visual analogue scale (VAS), range of motion (ROM) of knee, Lyshölm scores, Western Ontario and McMaster Universities (WOMAC) scores.

Results

The narrow intercondylar notch show in all 32 radiographs and sagittal magnetic resonance image showing with its attachment thickened and ill defined ACL. All patients received follow up. The mean follow up time was 21.16±5.53 months (15-32 months). The mean VAS score decreased significantly from 5.75±1.32 to 1.13±1.36 (t=13.44, P=0.00). Extension deficits decrease gradually from a mean angle of 11.62°±3.52° preoperatively. Almost stable 6 months postoperatively and the mean score was 0.41°±1.01° 1 year after operation. The extension deficit improved significantly. Manual Lachman tests and Anterior Drawer tests were all negative. At the same time, Lyshölm scores increased from 50.13±11.57 to 91.97±3.04 and WOMAC scores decreased from 35.13±7.88 to 6.25±2.78, which is statistically significant (t=-20.20, P=0.00; t=24.72, P=0.00).

Conclusion

Mucoid degeneration of the ACL has a typical clinical feature and the MRI findings are fairly specific for clinical diagnosis before arthroscopy. Arthroscopic debridement of mucoid hypertrophy of the ACL inconjunction with notchplasty can effectively provide symptomatic improvement without instability.