Management of Hypertrophic Anterior Cruciate Ligament Mucoid Degeneration by Arthroscopy

Abstract

Background: Mucoid degeneration of ACL is considered as an uncommon pathology. Most of the times it is underdiagnosed or wrongly diagnosed as partial rupture of ACL. Medical literature on ACL mucoid degeneration covers many case reports with few studies showing the treatment options with their outcomes and drawbacks. Aims: To assess the clinical, imaging features of mucoid degeneration of ACL with arthroscopic outcomes. Methodology: Clinical assessment with MRI as confirmatory diagnosis of ACL mucoid degeneration was considered as criteria for selection of the patients. All patients with traumatic injuries to the knee were ruled out. Patients with mucoid or ganglion cysts of ACL were not included in the study. Selected patients underwent arthroscopy. In arthroscopy the degenerative changes were studied and debridement of ACL fibers was done with preserving residual ACL fibers as much as possible. Result: Debridement of degenerated ACL with arthroscopy gives a good pain relief to the patient. It helps in improvement of flexion or extension deficits. No complications were accompanied with the procedure. ACL reconstruction was performed in only 1 patient in whom residual ACL fibers seemed insufficient. All other patients showed mild to moderate form of laxity. No evident instability was noted post operatively. Conclusion: ACL mucoid degeneration diagnosis needs a clinical suspicion with MRI for final diagnosis. Arthroscopic debridement is a good option for symptomatic relief and also helps with the moment deficits of the patient. However partial resection causes laxity during activity to the patients and instability remains a major drawback.