Association of mucoid degeneration of anterior cruciate ligament with knee meniscal and cartilage damage

R. M. Kwee, S. Ahlawat, A. J. Kompel, J. N. Morelli, L. M. Fayad, B. A. Zikria, S. Demehri

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective: To assess the prevalence of anterior cruciate ligament (ACL) mucoid degeneration in patients referred for routine knee magnetic resonance (MR) imaging, and its association with age and structural joint damage. Method: Four independent radiologists assessed 413 consecutive knee MR examinations for the presence of a normal or ruptured ACL, or ACL mucoid degeneration. Knees with ACL mucoid degeneration were frequency matched by age, sex, and MR field strength with consecutive control knees with a normal ACL (1:2 ratio). Differences in meniscal and cartilage damage of the tibiofemoral compartments, as determined by the Whole-Organ MR Imaging Score (WORMS) system, were compared by Mann-Whitney U tests. Multivariable logistic regression analysis identified the association of ACL mucoid degeneration with severe MTFC cartilage damage (WORMS≥5). Results: Patients with ACL mucoid degeneration ( n = 36; 36% males; median age 55.5 years, range: 26-81) were older than patients with a normal ( P < 0.001) or ruptured ACL ( P < 0.001), without sex predilection ( P = 0.76), and were more frequently diagnosed at 3 T (12%) compared to 1.5 T (2%). Knees with ACL mucoid degeneration had statistically significantly more medial meniscal ( P < 0.001) and central and posterior medial tibiofemoral compartment (MTFC) cartilage ( P < 0.001) damage compared with control knees ( n = 72), but there were no differences in patients ≤50 years ( P = 0.09 and 0.32, respectively). In multivariable logistic regression, severe MTFC cartilage damage (WORMS≥5) was significantly associated with ACL mucoid degeneration (odds ratio 4.09, 95% confidence interval 1.29-12.94, P = 0.016). Conclusion: There is a strong association between ACL mucoid degeneration and cartilage damage in the central and posterior MTFC, especially in patients >50 years.

Original languageEnglish (US)
Pages (from-to)1543-1550
Number of pages8
JournalOsteoarthritis and Cartilage
Issue number9
StatePublished - Sep 1 2015


  • Anterior cruciate ligament
  • Cartilage
  • Magnetic resonance imaging
  • Menisci
  • Mucoid degeneration
  • Osteoarthritis

ASJC Scopus subject areas

  • Rheumatology
  • Biomedical Engineering
  • Orthopedics and Sports Medicine


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