An Unusual Cause of Posterior Knee Pain: Mucoid Degeneration of the Anterior Cruciate Ligament - Case Report

Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon cause of pain in the posterior region of the knee, of unknown pathophysiology and underdiagnosed. The best treatment modality is still under discussion. Resection of the lesion with partial ACL debridement has shown good results without the occurrence of instability. The authors present a case of mucoid degeneration of the ACL treated with resection of the mucoid degeneration and partial debridement of the ACL by arthroscopy.

Keywords
anterior cruciate ligament; arthroscopy; knee joint

Authorship

Fabiano da Silva Marques Address for correspondence Fabiano da Silva Marques, MD, Avenida Nelsia Vannucci, 105, apto. 33, Campinas, São Paulo, 13042-104, Brasil, fabiano.s.marques@gmail.com

Department of Orthopedics, Instituto Wilson Mello, Campinas, São Paulo, BrazilInstituto Wilson MelloBrazilCampinas, São Paulo, BrazilDepartment of Orthopedics, Instituto Wilson Mello, Campinas, São Paulo, Brazil

Knee Surgery Group, Hospital da Pontifícia Universidade Católica de Campinas, Campinas, São Paulo, BrazilHospital da Pontifícia Universidade Católica de CampinasBrazilCampinas, São Paulo, BrazilKnee Surgery Group, Hospital da Pontifícia Universidade Católica de Campinas, Campinas, São Paulo, Brazil

https://orcid.org/0000-0002-2105-5743

Pedro Bezzan Rodrigues Alves

https://orcid.org/0000-0003-2316-8589

Sandro Zelada

https://orcid.org/0000-0001-6371-712X

Rodrigo Pereira da Silva Nunes

Department of Orthopedics, Pontifícia Universidade Católica de Campinas, Campinas, São Paulo, BrazilPontifícia Universidade Católica de CampinasBrazilCampinas, São Paulo, BrazilDepartment of Orthopedics, Pontifícia Universidade Católica de Campinas, Campinas, São Paulo, Brazil

Nunes Orthopedics and Traumatology Clinic (CNOT), Campinas, São Paulo, BrazilNunes Orthopedics and Traumatology ClinicBrazilCampinas, São Paulo, BrazilNunes Orthopedics and Traumatology Clinic (CNOT), Campinas, São Paulo, Brazil

https://orcid.org/0000-0003-3114-6232

Wilson Mello Alves

https://orcid.org/0000-0001-6161-926X

Gustavo Constantino de Campos

Department of Orthopedics, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, BrazilUniversidade Estadual de CampinasBrazilCampinas, São Paulo, BrazilDepartment of Orthopedics, Universidade Estadual de Campinas (Unicamp), Campinas, São Paulo, Brazil

https://orcid.org/0000-0001-7811-7354

Address for correspondence Fabiano da Silva Marques, MD, Avenida Nelsia Vannucci, 105, apto. 33, Campinas, São Paulo, 13042-104, Brasil, fabiano.s.marques@gmail.com

Conflict of Interests

The authors have no conflict of interests to declare.

Work developed in the Orthopedics Departments of UNICAMP and of Instituto Wilson Mello, Campinas, São Paulo, Brazil.

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Figures

Figures (5)

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Fig. 1
Preoperative clinical image.

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Fig. 2
Preoperative radiographs in anteroposterior, lateral and axial views of the patella of both knees.

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Fig. 3
T2-weighted MRI scan demonstrating hypertrophy of the anterior cruciate ligament (ACL), and signal increase without loss of continuity of its fibers - “celery stalk” sign.

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Fig. 4
Perioperative image of the arthroscopy of the right knee (A and B) showing signs of mucoid degeneration of the ACL; (C and D) aspect after debridement and partial resection of the degenerate portion of the ACL.

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Fig. 5
Graph 1: clinico-functional analysis.

Fig. 1 Preoperative clinical image.

Fig. 2 Preoperative radiographs in anteroposterior, lateral and axial views of the patella of both knees.

Fig. 3 T2-weighted MRI scan demonstrating hypertrophy of the anterior cruciate ligament (ACL), and signal increase without loss of continuity of its fibers - “celery stalk” sign.

Fig. 4 Perioperative image of the arthroscopy of the right knee (A and B) showing signs of mucoid degeneration of the ACL; (C and D) aspect after debridement and partial resection of the degenerate portion of the ACL.

Fig. 5 Graph 1: clinico-functional analysis.

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An Unusual Cause of Posterior Knee Pain: Mucoid Degeneration of the Anterior Cruciate Ligament - Case Report

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[1] Address for correspondence Fabiano da Silva Marques, MD, Avenida Nelsia Vannucci, 105, apto. 33, Campinas, São Paulo, 13042-104, Brasil, fabiano.s.marques@gmail.com