2026 · Clinics in Orthopedic Surgery
保存療法に反応しないACL粘液変性で、靱帯内ステロイド注射はどのような効果を示したか？
82膝中78膝（95.1%）で痛みが改善しました。可動域制限のあった50膝中49膝で制限が解消しました。
対象と方法
絵を読んだ順序です
主な結果
手術に関する読書のポイント
解釈の限界
簡単に説明しましょう
この研究で何が確認されましたか?
82膝中78膝（95.1%）で痛みが改善しました。可動域制限のあった50膝中49膝で制限が解消しました。
治療決定に直接適用できるか?
対照群がなく、ROMは診療記録の定性的な結果です。追跡MRIはありません。原著の6か月以上の疼痛緩和率は70.5%と61.0%で一致せず、この割合を確定した結果として示すことは困難です。
Keywords・キーワード
- Anterior cruciate ligament
- Fluoroscopy
- Glucocorticoids
- Knee joint
- Mucoid degeneration
- Anterior Cruciate Ligament
- Steroids
- Retrospective Studies
Abstract・原文の抄録
Sang Yoon Kim, Byung Sun Choi, Du Hyun Ro, Hyuk-Soo Han. Efficacy of Intraligamentous Steroid Injection in Pain Reduction and Knee Motion Improvement in Patients with Mucoid Degeneration of the Anterior Cruciate Ligament. Clinics in orthopedic surgery. 2026;18(4):658-665. doi:10.4055/cios25280.
BACKGROUND
This study assessed the efficacy and safety of fluoroscopy-guided intraligamentous steroid injections in managing mucoid degeneration of the anterior cruciate ligament (MDACL) in patients resistant to oral medication and intra-articular steroid injections.
METHODS
A retrospective review of 294 knees diagnosed with MDACL via magnetic resonance imaging between October 2014 and June 2023 was conducted. After applying exclusion criteria and excluding patients who were asymptomatic or showed improvement with conservative treatment, 82 knees were included in the final analysis. Intraligamentous steroid injections were performed under C-arm fluoroscopy by a single orthopedic surgeon. Clinical data collected included the duration of the pain-free period, patient-reported outcome measures (PROMs; pain numeric rating scale, the International Knee Documentation Committee subjective score, Lysholm score, and Knee Injury and Osteoarthritis Outcome Score), range of motion, and other radiological measures. Symptom recurrence rates were determined using the Kaplan-Meier survival analysis.
RESULTS
The average age at the time of injection was 64.0 years (range, 39-83 years), and the mean follow-up period was 19.5 months (range, 12-90 months). Pain improvement was noted in 78 of 82 knees (95.1%), with an average effect duration of 7.8 months (standard deviation, 9.1). Improvement of limitation of knee motion was observed in 49 of 50 cases (98.0%). Kaplan-Meier analysis indicated symptom recurrence rates of 19.5% at 3 months, 39.0% at 6 months, and 48.8% at 1 year. All PROMs significantly improved after injection for 6 months (p < 0.01) and then slightly declined. No patients reported post-procedure instability.
CONCLUSIONS
Fluoroscopy-guided intraligamentous steroid injection demonstrated short-term efficacy in relieving pain and improving knee motion in MDACL patients resistant to conventional treatments, although further studies are warranted to confirm these findings.
Copyright © 2026 by The Korean Orthopaedic Association
オリジナル紙だ
Efficacy of Intraligamentous Steroid Injection in Pain Reduction and Knee Motion Improvement in Patients with Mucoid Degeneration of the Anterior Cruciate Ligament
Sang Yoon Kim, Byung Sun Choi, Du Hyun Ro, Hyuk-Soo Han
Clinics in Orthopedic Surgery · 2026