Abstract
Purpose of the study: Cysts are rarely identified in the anterior cruciate ligament; the pathogenic mechanisms involved are poorly understood. We investigated the anatomic and clinical presentation.
Material and methods: This retrospective analysis included 24 patients, seven women and seventeen men managed in a single center from 1998 to 2004. Mean patient age was 45 years (range 25–74 years). All patients complained of pain. A preoperative MRI was available for all patients. Mean follow-up was 25 months (range 6–48 months). Arthroscopic procedures were used for 17 patients and the IKDC subjective score was determined preoperatively in all. Radioguided (US or CT) puncture was performed for seven patients associated with corticosteroid injections.
Results: On the MRI, there were 16 infiltrating cysts and eight cystic formations. Surgical treatment (n=17) was performed for 13 infiltrative cysts and for four cystic formations. There were two cases of recurrence. Outcome was poor after puncture (two puncture failures, three recurrences and one vascular complication).
Discussion: Two forms of cysts of the ACL can be demonstrated by MRI. The clinical presentation may not be different but the therapeutic management should be. The cystic formation is an indication for puncture, with arthroscopic treatment in the event of failure. For infiltrating cysts, complete resection of the cyst during an arthroscopic procedure is indicated, sometimes associated with resection of the ACL. Puncture yields poor results.
Correspondence should be addressed to SOFCOT, 56 rue Boissonade, 75014 Paris, France.
