title: Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  Systematic review, Level IV.
authors.affiliation: Andre Mignot Hospital of Versailles, Le Chesnay, France. francoislintz@gmail.com
authors.forename: Francois
authors.initials: F
authors.lastname: Lintz
authors.forename: Nicolas
authors.initials: N
authors.lastname: Pujol
authors.forename: Philippe
authors.initials: P
authors.lastname: Boisrenoult
authors.forename: Kevin
authors.initials: K
authors.lastname: Bargoin
authors.forename: Philippe
authors.initials: P
authors.lastname: Beaufils
authors.forename: David
authors.initials: D
authors.lastname: Dejour
mesh_terms: D016118:Anterior Cruciate Ligament / Q000473:pathology* / Q000601:surgery; D001182:Arthroscopy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D045888:Ganglion Cysts / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007592:Joint Diseases / Q000473:pathology* / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009093:Mucus / Q000378:metabolism*; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D018570:Risk Assessment; D013581:Synovial Cyst / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome