CASE REPORT article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1637907
This article is part of the Research TopicInnovations in Knee Preservation and Arthroplasty: Advancing Techniques and Technologies for Enhanced Surgical OutcomesView all 10 articles
Simultaneous Mucoid Degeneration of the ACL and PCL in a 62-Year-Old Man: An Under-Recognized Diagnostic Pitfall
Provisionally accepted
- 1Juan Nanoori Hospital, Incheon, Republic of Korea
- 2Nanoori Hospitals, Gangnam-gu, Republic of Korea
- 3Korea University Anam Hospital, Seoul, Republic of Korea
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Mucoid degeneration of the cruciate ligaments is an uncommon and often under-recognized cause of chronic knee pain and motion limitation. We report the case of a 62-year-old man with an eight-year history of discomfort, progressive flexion contracture, and restricted range of motion in the right knee. Two prior arthroscopies performed elsewhere failed to identify the cause. Magnetic resonance imaging using a 1.5-Tesla scanner with 3-mm slice thickness demonstrated diffuse, increased intraligamentous signal with intact fibers in both the anterior and posterior cruciate ligaments, consistent with the "celery stalk" sign. Arthroscopy through standard anterolateral and anteromedial portals revealed hypertrophic, yellowish ligament tissue in both cruciates. Approximately 50% of the bulk of each ligament was resected with preservation of the remaining intact fibers to maintain stability. Histologic examination confirmed mucoid degeneration without inflammatory infiltration. At six months postoperatively, the patient achieved full extension, improved flexion to 130°, and complete resolution of pain, without clinical instability. This case emphasizes the importance of considering simultaneous ACL and PCL mucoid degeneration as a potential diagnosis in patients with refractory knee stiffness when common intra-articular pathologies have been excluded.
Keywords: Knee, Anterior Cruciate Ligament, Posterior Cruciate Ligament, Mucoid degeneration, Arthroscopy
Received: 30 May 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Shin, Jang and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kyun-Ho Shin, Juan Nanoori Hospital, Incheon, Republic of Korea
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