the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. Initially, partial weightbearing is allowed. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Knee Surg Sports Traumatol Arthrosc. Meniscectomy was undertaken in 11 cases (41%). bling. The site is secure. Before Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. Orthop Traumatol Surg Res 96(4):400406, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. PubMed Bergin et al. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. 1 Its prevalence in magnetic resonance imaging (MRI) is 1.8-5.3%, but not all lesions are symptomatic.2, 3 It is characterized by infiltration of mucoid-like substance (glycosaminoglycans) interspersed within the Careers. The purpose of this study was to investigate the outcomes of management of mucoid degeneration of the anterior cruciate ligament (MDACL) by performing a systematic review of methods of treatment that have been reported. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. Seventeen females (67%) and eight males (33%) were included in the final analysis. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Postoperative recovery was four weeks on average. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Arthroscopic treatment of mucoid degeneration of the anterior cruciate Knee Surg & Relat Res 33, 26 (2021). An official website of the United States government. Anterior knee pain is the more common complaint. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. The clinical presentation is one of posterior pain with limited flexion. National Library of Medicine The extracted data were assessed for meta-analysis. Patient having mucoid degeneration of ACL seeks multiple orthopedic consultation and most of the time treating orthopedican miss its diagnosis either because of lack of experience or rare cause of pain unless doctor sought magnetic resonance imaging (MRI) of knee. ACL Insufficiency | Anterior Knee Instability | Knee Instability Federal government websites often end in .gov or .mil. What is Anterior Cruciate Ligament Mucoid Degeneration? Methods: The minimum follow-up was 3 years. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. HHS Vulnerability Disclosure, Help This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. 2012;4 (2): 167-70. The author(s) read and approved the final manuscript. 2006;69(9):44952. HHS Vulnerability Disclosure, Help With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. 2020 Jun 2. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Mucoid degeneration of the anterior cruciate ligament: a case report. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. The mean age of patients ranged from 31 to 78years. Results: Morice et al. On clinical examination, the active range of motion showed a flexion deficit. Truncation means that the . [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. 2007;15 (1): 73-86. Physical therapy typically begins 7-10 days after the procedure. 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. Khanna et al. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. . A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. Mucoid degeneration of ACL - Osteoporosis - inspire.com Four studies reported only postoperative scores, which were comparable to those in other studies. The .gov means its official. Mumbai, Maharashtra, India. Besides, the patient may also have trouble in moving. IV (retrospective cohort study). It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). We herein describe a case of PCL mucoid degeneration presented with secondary ACL . Careers. Signal intensity of the anteromedial bundle (AMB) or posterolateral bundle (PLB) graft standardized to the intensity of the PCL was defined as signal intensity ratio (SIR). Radiology. The need for simultaneous or delayed ACL reconstruction should be discussed with patients in case total resection of the ACL is to be performed, particularly in young active patients. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Would you like email updates of new search results? (100%). Clinical significance of T2*-weighted gradient-echo MRI to monitor Chudasama et al. Instrumental treatment. Results: Mucoid change or mucoid degeneration refers to the irreversible tissue degeneration due to the accumulation of mucin within the fibers of tendons, ligaments, and fibrocartilage. Bethesda, MD 20894, Web Policies Orthop Traumatol Surg Res. Introduction to Arthroscopic Debridement https://doi.org/10.1016/j.arthro.2003.11.030, Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 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). The mean follow up ranged from 13 to 72months. official website and that any information you provide is encrypted Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Mucoid degeneration of anterior cruciate ligament (ACL) Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Please enable it to take advantage of the complete set of features! In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. What you feel (symptoms) You feel heaviness in knee joint. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. This study concerns complete ACL resec Indian J Orthop 48(2):197202. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. 2001;30(6):312315. This makes it difficult to relate the improvement of symptoms to ACL debridement. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. JBR-BTR. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). sharing sensitive information, make sure youre on a federal The mean age at the time of surgery was 57 years (range, 31 to 78 years). just over two decades ago [], the interest in this condition has quickly gathered pace in the orthopaedic community.Little is known about this condition that affects 1.8-5.3% of the population as per magnetic resonance imaging (MRI) diagnosis [2, 3]. in 1999 [1]. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. National Center for Biotechnology Information and transmitted securely. Hypothesis: Careers. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. Score: 4.7/5 (45 votes) . (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). 2011;19(3):408411. Arthroscopic debridement of the ACL resulted in good pain relief and improved range of movement in all studies, with postoperative improvement in the knee scores. This site needs JavaScript to work properly. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. These appearances must be differentiated from mucoid degeneration of the intact ACL. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. reported on the co-existence of mucoid degeneration and ganglia of the ACL. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Arthroscopy. report that one patient had ACL reconstruction simultaneously after the ACL debridement. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, most pronounced at 6-7 and small disc herniations at 5-6 and C4-5, with slight interval progression at 5-6. . See this image and copyright information in PMC. Conclusions: The patient presented with extension block of the knee. [16]. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). PubMedGoogle Scholar. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. The primary intervention was arthroscopic ACL debridement in eight studies; this was combined with notchplasty in cases of impingement with the lateral wall of the notch in five studies [6, 14, 16,17,18] (Table 3). Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. 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. J Bone Joint Surg Br. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. AJR Am J Roentgenol. 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. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. in 1999 [ 1 ]. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Morice et al. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. Epub 2013 Aug 27. Online ahead of print. What causes mucoid degeneration of ACL? Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. Manage cookies/Do not sell my data we use in the preference centre. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. eCollection 2013. government site. Would you like email updates of new search results? 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. The appearance can mimic acute or chronic interstitial partial tears of the ACL. Conclusions: Mucoid degeneration of the ACL is a clinical condition afflicting active middle-aged people without a single significant traumatic episode with a specific MRI picture. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. The site is secure. How to Treat ACL Mucoid Degeneration? - HTQ A positive Lachman test and a negative pivot shift were noted after surgery in all cases. Hide glossary Glossary. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Discussion: Mucoid degeneration of the anterior cruciate ligament: can platelet This was lowest in the study of Cha et al. Mucoid degeneration itself is described as a yellow or brown substance which can be either seen through the most anterior fibers of the ACL or found by probing between them [ 19, 35] (Fig. PubMed Central 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Ligaments hold our bones together and allow us to bend, twist, pivot and rapidly accelerate and decelerate and yet maintain the stability of our joints. Therefore, indications for ACL resection must be carefully selected. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). By using this website, you agree to our Unauthorized use of these marks is strictly prohibited. [17] do not mention whether any patients underwent biopsy (Table 3). Arthroscopic findings. However, in most studies a proportion of patients simultaneously underwent other arthroscopic procedures for associated pathological knee conditions (44% meniscectomies in the study of Cha et al.). Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. Rehabilitation, speech therapy, crenotherapy. 1. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Background: This is a rare pathological condition, in which, there is increased signal from within the ligament. https://doi.org/10.2214/ajr.182.5.1821283, Article 2011. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. They respond well to a judicious arthroscopic release of the ACL with notchplasty. https://doi.org/10.4103/0019-5413.128765, Article Conclusions Our study provides further evidence that arthroscopic total or partial excision of anterior cruciate ligament is a safe and effective treatment for mucoid degeneration of the anterior . Arch Orthop Trauma Surg. Average patient age was 49 (22 to 68) years. Two patients uderwent secondary ligamentoplasty. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. However, the authors did not report whether there were any other patients with symptomatic instability. 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. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. MAUDE Adverse Event Report: GENZYME BIOSURGERY (RIDGEFIELD) SYNVISC ONE Noninfiltrating synovial cysts of the ACL were excluded. Read More Created for people with ongoing healthcare needs but benefits everyone. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. It is a chronic degenerative change of a bulky ACL that may lead to notch impingement syndrome in the absence of instability symptoms and significant trauma history [ 1, 2, 3, 4 ]. (61years), which was the largest study and represented more than one third of the total patients included in this review. Mucoid degeneration of the anterior cruciate ligament. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa.

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