Non-identical presentations of Intra-Articular Anterior Cruciate Ligament Ganglion Cysts: A report of two cases and review of literature

An uncommon cystic, tumor-like lesion of uncertain origin, an anterior cruciate ligament ganglion is encircled by dense connective tissue that is filled with a gelatinous fluid. Ganglion cysts and ACL mucoid degeneration may coexist. The size and location of the lesion determine how the lesion presents clinically. Two examples of ganglion cysts originating from the anterior cruciate ligament are presented here; one exhibits a painful restriction of flexion, while the other presents with chronic pain that is not related to motion restriction. With MRI, this uncommon clinical disease can be identified. It can be distinguished by magnetic resonance imaging (MRI) from pigmented villonodular synovitis, synovial sarcoma, mucoid degeneration of the ACL, and localized synovitis. It can be treated by arthroscopic cyst debridement or aspiration assisted by CT or USG. ACL damage must be prevented with caution. Following arthroscopic cyst debridement, both patients experienced a complete functional recovery. Conclusion: Although uncommon, ganglion cysts of the ACL should be considered a differential diagnosis for knee discomfort. Diagnosis is confirmed by MRI evaluation. Good clinical results can be achieved by arthroscopic debridement of cysts without causing ligament damage.