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  • Severe mucoid degeneration of the anterior cruciate ligament (ACL) treated with conservative arthroscopic debridement and platelet-rich plasma (PRP) injection

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Orthopaedics
Severe mucoid degeneration of the anterior cruciate ligament (ACL) treated with conservative arthroscopic debridement and platelet-rich plasma (PRP) injection
  1. Alexander Henry Seeto1,2,
  2. Mark Daniel Wilson3,
  3. Morgan McMeniman4 and
  4. Ivan Paul Astori5
  1. 1Queensland Health, Brisbane, Queensland, Australia
  2. 2Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Griffith University Faculty of Health, Gold Coast, Queensland, Australia
  3. 3QSports Medicine, Herston, Queensland, Australia
  4. 4Queensland X-Ray Pty Ltd, South Brisbane, Queensland, Australia
  5. 5Brisbane Orthopaedic and Sports Medicine Centre, Spring Hill, Queensland, Australia
  1. Correspondence to Dr Alexander Henry Seeto; alexander.seeto{at}griffithuni.edu.au

Abstract

Mucoid degeneration of the anterior cruciate ligament (ACL) can be treated with arthroscopic debridement, however, instability can ensue. Here, we present a fit and active woman in her 60s with severe mucoid degeneration of the ACL who underwent conservative arthroscopic debridement and treatment with intraligamentous administration of platelet-rich plasma (PRP). After 1 month, the patient demonstrated significant improvements in range of motion and pain symptoms, with nil resultant laxity. The patient was able to return to all recreational sporting activities and professional duties. Quantitative MRI conducted 6 months postoperatively revealed improved fibre orientation and formation of new parallel fibres. Compared with the preoperative scan, the mean grey value demonstrated darker pixel intensity with a smaller standard deviation (SD), potentially indicating a more uniform and less variable formation of ligamentous tissue. Therefore, PRP did not cause harm and was associated with benefit in combination with arthroscopic debridement.

  • Orthopaedics
  • Orthopaedic and trauma surgery
  • Ligament laxity
  • Physiotherapy (sports medicine)

https://doi.org/10.1136/bcr-2023-257217

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    Footnotes

    • Contributors AHS, MDW, MM and IPA were responsible for drafting the text, sourcing and editing the clinical images, investigation results, drawing original diagrams and algorithms, and critical revision of important intellectual content. AHS, MDW, MM and IPA gave final approval of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.