title: Association of mucoid degeneration of anterior cruciate ligament with knee meniscal and cartilage damage.
abstract: OBJECTIVE
  To assess the prevalence of anterior cruciate ligament (ACL) mucoid degeneration in patients referred for routine knee magnetic resonance (MR) imaging, and its association with age and structural joint damage.
  
  
  METHODS
  Four independent radiologists assessed 413 consecutive knee MR examinations for the presence of a normal or ruptured ACL, or ACL mucoid degeneration. Knees with ACL mucoid degeneration were frequency matched by age, sex, and MR field strength with consecutive control knees with a normal ACL (1:2 ratio). Differences in meniscal and cartilage damage of the tibiofemoral compartments, as determined by the Whole-Organ MR Imaging Score (WORMS) system, were compared by Mann-Whitney U tests. Multivariable logistic regression analysis identified the association of ACL mucoid degeneration with severe MTFC cartilage damage (WORMS≥5).
  
  
  RESULTS
  Patients with ACL mucoid degeneration (n = 36; 36% males; median age 55.5 years, range: 26-81) were older than patients with a normal (P < 0.001) or ruptured ACL (P < 0.001), without sex predilection (P = 0.76), and were more frequently diagnosed at 3 T (12%) compared to 1.5 T (2%). Knees with ACL mucoid degeneration had statistically significantly more medial meniscal (P < 0.001) and central and posterior medial tibiofemoral compartment (MTFC) cartilage (P < 0.001) damage compared with control knees (n = 72), but there were no differences in patients ≤50 years (P = 0.09 and 0.32, respectively). In multivariable logistic regression, severe MTFC cartilage damage (WORMS≥5) was significantly associated with ACL mucoid degeneration (odds ratio 4.09, 95% confidence interval 1.29-12.94, P = 0.016).
  
  
  CONCLUSIONS
  There is a strong association between ACL mucoid degeneration and cartilage damage in the central and posterior MTFC, especially in patients >50 years.
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: R M
authors.initials: RM
authors.lastname: Kwee
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: S
authors.initials: S
authors.lastname: Ahlawat
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: A J
authors.initials: AJ
authors.lastname: Kompel
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: J N
authors.initials: JN
authors.lastname: Morelli
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: L M
authors.initials: LM
authors.lastname: Fayad
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
authors.forename: B A
authors.initials: BA
authors.lastname: Zikria
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: demehri2001@yahoo.com.
authors.forename: S
authors.initials: S
authors.lastname: Demehri
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D006801:Humans; D007717:Knee / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D015588:Observer Variation
keywords: Anterior cruciate ligament; Cartilage; Magnetic resonance imaging; Menisci; Mucoid degeneration; Osteoarthritis