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Case report: intra-tendinous ganglion of the anterior cruciate ligament in a young footballer

Rolf, C. and Watson, T.P. (2006) Case report: intra-tendinous ganglion of the anterior cruciate ligament in a young footballer. Journal of Orthopaedic Surgery and Research, 1 (11). ISSN 1749-799X

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Abstract

A 20-year-old male medical student and keen rugby player presented with a 12-month history of progressively worsening right knee pain and stiffness with no history of trauma. Clinical examination revealed effusion and posterior knee pain exacerbated by end range movement and an extension lag of 15 degrees. Physiotherapy to improve the range of motion proved unsuccessful. Magnetic resonance imaging showed that the ACL was grossly thickened and displaced by material reported as mucoid in nature. There were also areas of focally high signal in relation to its tibial attachment and intra osseous small cysts. Arthroscopic examination revealed a ganglion related to the tibial attachment of the ACL and gross thickening and discoloration of the ACL. Biopsies were taken showing foci of mucoid degeneration in the ACL. A large intra-ACL mass of brownish coloured tissue was excised arthroscopically. Already at 2 weeks follow up the patient had greatly improved range of movement and was pain free. However, upon returning to rugby, joint instability was noticed and a tear of the ACL was confirmed.

This rare clinical condition can be diagnosed with MRI and arthroscopic debridement effectively relieves symptoms. This case report illustrates that augmentation or reconstruction may end up being the definitive treatment for athletes. It may also offer some support to the argument that mucoid degeneration and ganglion cyst formation share a similar pathogenesis to intra-osseous cyst formation.

Item Type: Article
Copyright, Publisher and Additional Information: © 2006 Rolf and Watson; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Institution: The University of Sheffield
Academic Units: The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine (Sheffield) > Clinical Sciences Division South (Sheffield)
Depositing User: Sherpa Assistant
Date Deposited: 22 Jan 2007
Last Modified: 05 Jun 2014 21:40
Published Version: http://www.josr-online.com/content/1/1/11
Status: Published
Publisher: BioMed Central
Refereed: Yes
Identification Number: 10.1186/1749-799X-1-11
URI: http://eprints.whiterose.ac.uk/id/eprint/1915

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