Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament.

OBJECTIVE

To assess the effectiveness of ultrasound-guided decompression in managing symptomatic mucoid degeneration of the anterior cruciate ligament (ACL).

MATERIALS AND METHODS

Retrospective analysis of 55 patients who underwent ultrasound-guided ACL mucoid degeneration decompression between July 2013 and August 2019. Subjective satisfaction scores were gathered immediately post-procedure for all 55 patients; follow-up satisfaction scores (scale of 0-10, 10 being excellent) were gathered telephonically for 46 patients (83.6%) up to 63 months post-procedure. Follow-up duration of each patient was classified as short (1-6 months), intermediate (7-12 months), or long (more than 12 months) post-procedure. Forty-five patients (81.8%) MRI were retrospectively analyzed and classified into cystic (n = 13, 28.9%), mucoid (n = 11, 24.4%), or mucoid-cystic (21, 46.7%) types. Multivariate logistic regression was used to identify associations between follow-up satisfaction score, follow-up duration, patient age, and type of ACL degeneration.

RESULTS

All patients had immediate marked post-procedure improvement, with excellent (>7/10) satisfaction scores. Forty-six of 55 patients were telephonically followed up: 21 (45.6%) short-term interval, 18 (39.1%) intermediate term, and 7 (15.2%) long-term. Thirty (65.22%) patients had excellent and eight (17.4%) patients had average satisfaction scores at follow-up. Eight (17.4%) patients had poor post-procedure satisfaction scores within six months. There were no significant associations between immediate or follow-up satisfaction score and duration of follow-up, age of patient, or type of ACL degeneration.

CONCLUSION

Ultrasound-guided aspiration, fenestration, and injection are an effective, safe, minimally invasive and radiation-free technique for management of mucoid degeneration of ACL with excellent immediate- and long-term results.