Evaluation of Ligamentum Mucosum in Anterior Cruciate Ligament Injuries

Ligamentum Mucosum in ACL Injuries

Abstract

Objective: The ligamentum mucosum (LM) was once thought to be a remnant of embryological development. However, recent studies have shown that its structure is similar to that of other ligaments in the knee. Over the past few years, histopathological studies have shown that the LM contains neural and vascular structures. This suggests that this ligament could potentially be used for proprioception and revascularization in the repair of the anterior cruciate ligament (ACL). The aim of this study was to evaluate the structure of the LM in knees with ACL injuries. Our hypothesis is that in cases of chronic ACL injury, the intact LM is likely to be less common. 

Materials and Methods: The data of patients who underwent knee arthroscopy in our clinic between 2017 and 2022 were analyzed retrospectively. Three groups were included in the study: acute ACL tears (n= 89), chronic ACL tears (n=111) and intact ACLs (n= 101). Arthroscopic video records of all patients were evaluated retrospectively. LM was defined in three different forms as intact, ruptured, and non-presence in the groups.

Results: The non-presence of the LM was significantly more common in chronic ACL tears compared to the other groups (p<0.05), while the presence of the LM (whether intact or ruptured) was similar between acute ACL tears and intact ACLs. In acute tears, intact LM was significantly lower compared to intact ACLs (p<0.05). However it was significantly higher compared to chronic tears (p<0.05).

Conclusions: In this study, we concluded that the probability of an intact LM in chronic ACL tears is relatively low.