Mucoid degeneration of the anterior cruciate ligament: Management and outcome

BACKGROUND

Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Mucinous material within the substance of ACL produces pain and limited motion in the knee. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes.

MATERIALS AND METHODS

During a period of 3 years, 11 patients were included based upon the clinical suspicion, magnetic resonance imaging (MRI) findings, arthroscopic features and histopathologic confirmation of MD of ACL.

RESULT

Six patients were male and five were female with median age of 40 years (range 21-59 years). All patients complained of knee pain with median duration of 5 months (range 1-24 months). All patients had painful deep flexion with 63.6% (N = 7) reporting trivial trauma before the onset of symptoms. MRI revealed MD of ACL in all with associated cyst in three patients. Partial debridement of ACL was done in ten and complete in one patient. None of them required notchplasty. Histopathology confirmed the diagnosis in all of them. At the mean followup of 13.81 months (range 6-28 months), all patients regained complete flexion and none complained of instability.

CONCLUSION

Prior knowledge of condition with high index of suspicion and careful interpretation of MRI can establish the diagnosis preoperatively. It responds well to partial debridement of ACL and mucinous material without development of instability.

Helping the chronic schizophrenic and their families in the community-intial observations

There is a growing interest in the problems of mentally ill persons in the community in order to understand and organize services for them. Schizophrenia continues to form the most important problems in the community. The present prospective study involved thirty patients with chronic schizophrenia and their families. The study involved the intensive understanding of the social problems of the patients and families as well as the interventions to manage the problems isolated.THE STUDY REVEALED THE FOLLOWING AREAS TO THE SOURCE OF PROBLEMS OF ADJUSTMENT: (i) High expectations of the family, (ii) Excessive emotional involvement, (iii) Marital disturbances, (iv) Problems of employment and (v) Problems relating to long term treatment.The techniques employed in the management were, in addition to long-acting phenothiazines were: (i) periodic and regular home visits, (ii) family financial counselling, (iii) explanation about the illness to enhance treatment acceptance, and (iv) contact with social welfare agencies. The paper is largely descriptive and illustrations of cases are included to highlight the salient aspects of the experience.