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The extracted data were assessed for meta-analysis. Level of evidence: Mucoid degeneration of both ACL and PCL - PubMed Coronal proton density-weighted magnetic resonance, Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate, Sagittal proton density-weighted magnetic resonance, Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased, Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate, Pre-debridement arthroscopic view showing yellowish. Indian J Orthop 48(2):197202. FOIA have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. 1. TS designed the project, literature search and wrote the manuscript. Unable to load your collection due to an error, Unable to load your delegates due to an error. government site. Knee Surgery & Related Research -. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. Mucoid degeneration of the anterior cruciate ligament reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. 3. Before It has recently been postulated that mucoid degeneration of the ACL is related to the medial knee compartment joint space loss in patients with osteoarthritis or in the OA risk group 6. Preoperative magnetic resonance imaging (MRI) scan. Sweed, T., Mussa, M., El-Bakoury, A. et al. AJR Am J Roentgenol. J Orthop. Unable to process the form. Anatomopathology samples were collected in 18 cases. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. https://doi.org/10.1016/j.jclinepi.2009.06.005. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. 1. https://doi.org/10.1007/s00167-011-1433-0, Article Hide glossary Glossary. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Pain was posterior in 23 knees (80%). An anterior cruciate ligament (ACL) mucoid degeneration, along with tears and anterior cruciate ligament ganglion cysts, is a relatively common cause of increased signal within the. What does mucoid degeneration of posterior horn of medial - HealthTap Arthroscopic treatment of mucoid degeneration of the anterior cruciate Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. Skeletal Radiol. All patients (100%, n=11) reported an improvement in pain. and transmitted securely. sharing sensitive information, make sure youre on a federal Seventeen females (67%) and eight males (33%) were included in the final analysis. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Clin Orthop Surg. The total number of patients with symptomatic instability was 18 out of 288 (6%). Anterior cruciate ligament mucoid degeneration. 6. Mucoid degeneration of ACL Justamom21 Feb 17, 2023 7:27 AM Among other conditions - osteoarthritis, osteopenia, spondylolisthesis- an MRI report showed "severe mucoid degeneration of the ACL" in my left knee. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. All nine studies were case series; six were retrospective and three were prospective studies. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Intact fibers are best seen on T2WI. The rate of simultaneous meniscectomy ranged from 13 to 44%. Check for errors and try again. Anterior cruciate ligament mucoid degeneration: Selecting the best AJR Am J Roentgenol. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2023 BioMed Central Ltd unless otherwise stated. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. MRI - Interstitial ACL tear With Mild knee joint effusion ,No evidence of discontinuation of fibre Can Interstitial ACL tear heal without surgery Asked for Male, 22 Years 78 Views v Dr. Abhishek Kaushik Joint Replacement Surgeon | Delhi 1/1 people found this helpful Hi. . Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Mucoid degeneration of the ACL is suspected when an apparently thickened and ill-defined ligament with increased signal intensity on all sequences in MRI is identified in a patient with physically intact ligament and no obvious trauma history. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. and Ventura et al. The mean follow up ranged from 13 to 72months. Please enable it to take advantage of the complete set of features! Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. 2009. Please enable it to take advantage of the complete set of features! Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. Provided by the Springer Nature SharedIt content-sharing initiative. Anterior cruciate ligament mucoid degeneration: selecting the best In the Lintz study, total resection of the ACL was performed in 17 out of 29 knees, while in the Ventura study total resection was performed in 17 out of 25 patients. Arthroscopy 24(6):642649. -. Truncation means that the . Arch Orthop Trauma Surg. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. 2011. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. MeSH All rights reserved. https://doi.org/10.1046/j.1445-2197.2003.02748.x, Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a systematic review. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. What you feel (symptoms) You feel heaviness in knee joint. What is Anterior Cruciate Ligament Mucoid Degeneration? Unable to load your collection due to an error, Unable to load your delegates due to an error. Conclusions: 2011. Characteristic: "celery stalk" appearance. Chudasama et al. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. 8600 Rockville Pike AJR Am J Roentgenol. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. FOIA Reeducation. Radiology. Twelve partial and 17 total resections were performed. Arthroscopic findings. https://doi.org/10.2214/ajr.182.5.1821283, Article Generally, we know little about this condition. Unlike meniscal tears and chondral defects, the mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain and there have been no case reports of mucoid degeneration of both the ACL and the posterior cruciate ligament (PCL). The site is secure. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. https://doi.org/10.1016/j.jajs.2015.12.001, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J (2018) Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. J Chin Med Assoc. Knee. Epub 2011 Feb 18. Orthop Traumatol Surg Res. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment Reeducation. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Hypothesis: Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. That is usually the journal article where the information was first stated. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Categories were determined in accordance with the study of Ekhtiari et al. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. The mean follow up ranged from 13 to 72months. Methods: 2011;19(3):408411. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). J Arthrosc Joint Surg 3(1):2833. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. sharing sensitive information, make sure youre on a federal The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. government site. After the literature search and exclusion of duplicates, 54 papers were retrieved: 12 articles were assessed for eligibility, and of these, 9 papers met the inclusion criteria and were included in the systematic review [3, 6, 13,14,15,16,17,18,19] (Fig. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Mucoid degeneration of the anterior cruciate ligament Mucoid degeneration of the anterior cruciate ligament. Before Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon non-traumatic cause of knee pain and motion restriction, typically seen in a middle-aged population. This is a rare pathological condition, in which, there is increased signal from within the ligament. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Postoperative recovery was four weeks on average. On clinical examination, the active range of motion showed a flexion deficit. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. Careers. Accessed 1 Mar 2021. For non-comparative studies, this consists of eight questions. At the time the article was created Frank Gaillard had no recorded disclosures. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Roberts CC, Towers JD, Spangehl MJ et-al. MM and A performed the literature search, and data analysis. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Symptomatic ACL mucoid degeneration in middle-age athletes. Knee Surg Sports Traumatol Arthrosc. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . The patient presented with extension block of the knee. . Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first described in the literature in 1999.1 Since then, MD-ACL has been recognized as a pathology present on between 0.7% and 5.3% of magnetic resonance images performed for knee pain.2 MD-ACL is thought to be part of a spectrum of ACL disease that can range from ganglion cysts to MD.3 MD-ACL can either be primary (idiopathic . The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Bookshelf Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. The aetiology of MDACL is not clearly understood. Treatment options include non-operative management, arthroscopic debridement with a biceps tenotomy or tenodesis, complete or partial repair, patch augmentation, superior capsular reconstruction, muscle/tendon transfer and reverse total shoulder arthroplasty. 8600 Rockville Pike Ayurvedic treatment for complete acl tear - Practo The site is secure. 5. PDF Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration: A Review Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Besides, the patient may also have trouble in moving. Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. Google Scholar, Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D (2011) Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Mucoid Degeneration Of Acl Treatment? The 140 Top Answers ANZ J Surg 73(9):712716. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Preoperative magnetic resonance imaging (MRI), Fig. Mucoid degeneration of the anterior cruciate ligament: can platelet Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Instrumental treatment. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Ligaments and tendons are accumulated by mucoid change might display a thickened and/or hypertrophied appearance, with an increase in signal intensity. . In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Symptomatic ACL mucoid degeneration in middle-age athletes Arthroscopic diagnostic criteria [7] are (1) continuous ACL fibres, (2) increased ACL volume, (3) yellowish-coloured material expressed on palpation and (4) loss of ACL synovial lining. The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment. Mucoid degeneration of the anterior cruciate ligament: Partial J Knee Surg. sharing sensitive information, make sure youre on a federal in 1999 [ 1 ]. Clinical Outcomes, Return to Sports, and Patient Satisfaction After Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients in an Asian Population-A 2-Year Follow-up Study. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. -Evaluated and planned treatment protocol in accordance with physician. (48.2% (14/29 patients) with symptomatic instability), which may be due to the large number of patients with total resection of the ACL (58.6% (17 out of 29 patients)) (Table 4). 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Conclusions. What is myxoid degeneration treatment? All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Questions just answered: mucoid degeneration of acl physiotherapy. This ranged from 90 to 95% in all studies, except in the report by Kim et al., where only 53.8% of patients (57/106) had complete pain relief after surgery. This may support the theory that it is a degenerative process. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). When refering to evidence in academic writing, you should always try to reference the primary (original) source. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). mucoid degeneration of acl mri. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. FOIA It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. As there was no control group in any of the studies and the natural history of MDACL is not known, the postoperative improvement may have been attributed to the placebo effect, simultaneous arthroscopic procedures or the postoperative rehabilitation, or may be due to the pain having resolved without treatment at all. FOIA Indian J Orthop 46(5):561565. Partial Anterior Cruciate Ligament - ACL - Tears - Howard J. Luks, MD 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. eCollection 2022 May-Jun. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Average postoperative International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were 71.2 (42.5 to 92.0) and 78.2 (26.4 to 99). 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. HHS Vulnerability Disclosure, Help Joshita Poojary - Sports Physical Therapist - Padmanabhan's - Linkedin Physical therapy typically begins 7-10 days after the procedure. NCI CPTC Antibody Characterization Program. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Tamer Sweed. However, MDACL is asymptomatic in most patients. Mumbai, Maharashtra, India. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2 ). Mucoid cystic degeneration of the cruciate ligament. Magn Reson Imaging Clin N Am. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). MeSH Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Knee Surg Sports Traumatol Arthrosc. Download Citation | On Feb 1, 2023, O.R.