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What are the findings from the knee MRI and required treatment?

Feb 2014
User rating for this question
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5931 Questions
Would like help with interpretation of MRI result of KNEE have extensive surgical Hx. Currently have intermittent instability limited ROM with Effusion and Pain. 1) ACL reconstruction demonstrates Moderate thinning with cystic degeneration of tibial and femoral tunnels. 2) Tear posterior horn of medial meniscus What does this mean and what is typical course of action for # 1 i'm familiar with treatment options for #2
Posted Mon, 6 Jan 2014 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 1 hour later
Brief Answer: Cystic degeneration/reaction ACL graft reconstruct Detailed Answer: Hello, Thanks for your query. Your MRI report suggestive of Cystic degeneration/reaction ACL graft reconstruction. This cystic degeneration is due to cystic fluid within the graft known as ACL graft ganglion. Graft ganglia rarely lead to graft disruption, but operative resection of these ganglia may be necessary for relief of pain and/or mechanical symptoms. I do hope that you have found something helpful and I will be glad to answer any further query. Take care
Above answer was peer-reviewed by
Follow-up: What are the findings from the knee MRI and required treatment? 39 minutes later
In regards to moderate thinning of graft what could cause this? Also Cystic degeneration is mentioned in Tibial and Femoral Tunnels. Not specifically in graft itself. There doesn't seem to be much literature on this but what I have found this may relates to technique used and hardware during original procedure. Not sure if there is difference between cystic degeneration of graft itself or bone sites used to secure graft. just trying to clarify. Would this cause the instability issues?
Answered by Dr. Saurabh Gupta 24 hours later
Brief Answer: These degeneration would cause instability issues. Detailed Answer: Cause of cystic degeneration of tunnels are multifactorial , including biological and mechanical contributions. Cystic degeneration of graft can lead to cystic degeneration of tunnels. This may relate to tunnel placement, technique used and hardware. These degeneration would cause instability issues.
Above answer was peer-reviewed by
Follow-up: What are the findings from the knee MRI and required treatment? 13 minutes later
Since cystic degeneration appears to involve tunnels would treatment change IE: require Complete ACL REVISION? Or can current graph be salvaged with resection and curettage?
Answered by Dr. Saurabh Gupta 17 hours later
Brief Answer: Require complete ACL revision Detailed Answer: As there is tuunnel widening due to cystic degeneration and moderate thining of ACL graft causing instability issues, it require complete ACL revision.
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