Gonzalo Samitier Solís1, Chaitanya Waghchoure2, Gustavo Vinagre3,4. 1. Department of Orthopaedic Surgery and Traumatology, Centro Quirónsalud Aribau, Barcelona, Spain. 2. Department of Orthopaedics, B. J. Government Medical College and Sasson General Hospital, Pune, India. 3. Department of Orthopaedic Surgery and Traumatology, Complexo Hospitalar do Médio Ave, Porto, Portugal. 4. Department of Orthopaedic Surgery and Traumatology, Hospital Lusíadas Porto, Porto, Portugal.
Abstract
Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon non-traumatic cause of knee pain and motion restriction, typically seen in a middle-aged population. Primarily, the management consists of partial arthroscopic debridement and notchplasty, which has proven satisfactory clinical and functional outcomes. Study objectives: This review aims to highlight key clinical, radiological and arthroscopic findings of mucoid ACL degeneration, and also to provide an approach to manage a symptomatic middle-aged athlete. Rationale: Due to the paucity of literature on ACL mucoid degeneration, symptomatic presentation in a middle-aged athlete can be challenging to manage. Diffuse central pain, motion restriction in extension or flexion, absence of trauma, and an intact enlarged ACL on Magnetic resonance imaging (MRI) should raise suspicion for mucoid degeneration in middle-aged athletes. Specific radiological and arthroscopic findings can help to confirm the diagnosis. In this review article, we have also described a new clinical test to mimic the pain due to anterior impingement in the presence of an enlarged ACL. Conclusion: In symptomatic middle-aged athletes, knowledge of characteristic findings can help in the timely diagnosis of mucoid degeneration of ACL. Treatment options include arthroscopic debridement, notchplasty, ACL augmentation, and ACL reconstruction. The presence of associated injuries can influence return-to-sports prognosis.
Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon non-traumatic cause of knee pain and motion restriction, typically seen in a middle-aged population. Primarily, the management consists of partial arthroscopic debridement and notchplasty, which has proven satisfactory clinical and functional outcomes. Study objectives: This review aims to highlight key clinical, radiological and arthroscopic findings of mucoid ACL degeneration, and also to provide an approach to manage a symptomatic middle-aged athlete. Rationale: Due to the paucity of literature on ACL mucoid degeneration, symptomatic presentation in a middle-aged athlete can be challenging to manage. Diffuse central pain, motion restriction in extension or flexion, absence of trauma, and an intact enlarged ACL on Magnetic resonance imaging (MRI) should raise suspicion for mucoid degeneration in middle-aged athletes. Specific radiological and arthroscopic findings can help to confirm the diagnosis. In this review article, we have also described a new clinical test to mimic the pain due to anterior impingement in the presence of an enlarged ACL. Conclusion: In symptomatic middle-aged athletes, knowledge of characteristic findings can help in the timely diagnosis of mucoid degeneration of ACL. Treatment options include arthroscopic debridement, notchplasty, ACL augmentation, and ACL reconstruction. The presence of associated injuries can influence return-to-sports prognosis.