Arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament / 中华骨科杂志

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 treat?ment. 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, Lysh?lm scores, Western On?tario and McMaster Universities (WOMAC) scores. Results The narrow intercondylar notch show in all 32 radiographs and sagit?tal 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 sta?ble 6 months postoperatively and the mean score was 0.41° ± 1.01° 1 year after operation. The extension deficit improved signifi?cantly. Manual Lachman tests and Anterior Drawer tests were all negative. At the same time, Lysh?lm 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 find?ings are fairly specific for clinical diagnosis before arthroscopy. Arthroscopic debridement of mucoid hypertrophy of the ACL in conjunction with notchplasty can effectively provide symptomatic improvement without instability.