Andre Mignot Hospital of Versailles, Le Chesnay, France.
Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Epub 2011 Feb 18.
Anterior cruciate ligament (ACL) mucoid degeneration is a rare encounter in clinical practice, different, but often confused with ACL mucoid cysts. Its pathophysiology remains unclear. However, recent publications have suggested that it might be underdiagnosed or misdiagnosed, and that the adverse effects of treatment by ACL resection might be underestimated. The object of this work was to summarize this scattered knowledge to improve patient management.
The authors carried out an exhaustive and comprehensive review of up-to-date literature. An extensive search of the MEDLINE database was carried out using MESH terms (ganglion cyst, anterior cruciate ligament) and generic search terms (mucoid degeneration, hypertrophy).
Anterior cruciate ligament mucoid degeneration is determined by interstitial glycosaminoglycan deposits amidst the collagen bundles causing ACL hypertrophy, knee pain, and limited range of motion. It is thought to arise from a primary synovial lesion and is associated with arthritic change or subsequent to acute or repeated trauma. Diagnosis is made on MRI scans and confirmed on histopathological samples. Current treatment involving ACL arthroscopic resection is efficient on pain and range of motion but is not a benign procedure and causes knee laxity.
Anterior cruciate ligament mucoid degeneration needs to be more broadly known and properly diagnosed so that progress can be made in its management. Further research will be necessary to confirm the current trends in the literature, which suggest being less aggressive with ACL arthroscopic resection when dealing with mucoid degeneration and making more use of conservative measures such as notchplasty.
Systematic review, Level IV.
前交叉韧带（ACL）黏液样变性在临床实践中较为罕见，与 ACL 黏液样囊肿不同，但常被混淆。其病理生理学仍不清楚。然而，最近的出版物表明，它可能被漏诊或误诊，ACL 切除的治疗效果可能被低估。本研究的目的是总结这些分散的知识，以改善患者的管理。
作者对最新文献进行了全面彻底的回顾。使用 MESH 术语（神经节囊肿、前交叉韧带）和通用搜索词（黏液样变性、肥大）对 MEDLINE 数据库进行了广泛搜索。
ACL 黏液样变性是由胶原束之间的间质糖胺聚糖沉积引起的 ACL 肥大、膝关节疼痛和活动范围受限。它被认为是由原发性滑膜病变引起的，与关节炎改变或急性或反复创伤有关。诊断依据是 MRI 扫描和组织病理学样本。目前的治疗方法是对膝关节镜下 ACL 切除，可有效缓解疼痛和活动范围受限，但不是一种良性手术，会导致膝关节松弛。
需要更广泛地了解和正确诊断 ACL 黏液样变性，以便在其治疗方面取得进展。需要进一步的研究来证实目前文献中的趋势，即在处理黏液样变性时，对膝关节镜下 ACL 切除的治疗应不那么激进，并更多地采用保守措施，如切迹成形术。
系统评价，IV 级。
