Percutaneous image-guided treatment of mucoid degeneration of the ACL in advanced knee osteoarthritis-Preliminary observations

Ir J Med Sci. 2024 Jun;193(3):1527-1531. doi: 10.1007/s11845-024-03606-8. Epub 2024 Feb 13.

Abstract

Objectives: To describe the percutaneous image-guided treatment of mucoid degeneration of the ACL causing deep knee pain on flexion in patients with advanced knee osteoarthritis.

Methods: Five patients with mucoid degeneration of the ACL complicating knee osteoarthritis underwent percutaneous image-guided steroid bupivacaine ACL sleeve injections over a 3-year period.

Results: There were four males and one female of mean age 54 (range 48-59 years). Each patient had Kellgren and Lawrence grade 4 medial compartment knee osteoarthritis with coexistent mucoid degeneration of the ACL sleeve. Each patient complained of deep knee pain on flexion as a dominant symptom. Each patient underwent image-guided (CT or ultrasound) steroid bupivacaine injection of the ACL sleeve resulting in symptom resolution and improved mobility for a mean duration of 8 months, (range 6-15 months.) CONCLUSION: Mucoid degeneration of the ACL should be sought in patients with osteoarthritis presenting with deep knee pain on flexion. Image-guided ACL sleeve injection in affected patients may result in symptom resolution and potential deferral of planned knee replacement surgery.

Advances in knowledge: Emphasises Image guided percutaneous treatment of Mucoid degeneration of ACL in patients with knee osteoarthritis.

Keywords: ACL; Intervention; Knee; MRI; Mucoid degeneration; Osteoarthritis.

MeSH terms

  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Anterior Cruciate Ligament* / surgery
  • Bupivacaine / administration & dosage
  • Bupivacaine / therapeutic use
  • Female
  • Humans
  • Injections, Intra-Articular
  • Male
  • Middle Aged
  • Osteoarthritis, Knee* / complications
  • Osteoarthritis, Knee* / surgery

Substances

  • Bupivacaine
  • Anesthetics, Local