Sagittal T2-weighted MRI view showing intact anterior, Fig. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients.Materials and MethodsBetween December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis . The site is secure. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). Therefore, indications for ACL resection must be carefully selected. In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. The https:// ensures that you are connecting to the Epub 2013 Aug 27. https://doi.org/10.1007/s00167-012-1991-9, McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. in 1999 [1]. Skelet Radiol 30(6):312315. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. volume33, Articlenumber:26 (2021) The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. There was an improvement in postoperative range of motion and outcome scores (Lysholm and International Knee Documentation Committee scores and the Knee Injury and Osteoarthritis Outcome Score). Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. AJR Am J Roentgenol. Arthroscopy. Epub 2011 Feb 18. What is myxoid degeneration treatment? The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. Mumbai, Maharashtra, India. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. Disclaimer. official website and that any information you provide is encrypted The .gov means its official. FOIA 8600 Rockville Pike Cookies policy. The reported restriction of range of movement was flexion deficit in four studies [3, 13, 15, 17], extension deficit in one study [14] and combined flexion and extension deficit in four studies [6, 16, 18, 19] (Table4). Mucoid degeneration of the anterior cruciate ligament. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. HHS Vulnerability Disclosure, Help Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. Knee. 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. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. The mean follow up ranged from 13 to 72months. Knee Surg Sports Traumatol Arthrosc 21(3):658663. It can cause pain and to a meniscal tear. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. FOIA MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Knee Surg Sports Traumatol Arthrosc. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Mucoid degeneration of A C L is more common and literature has also reported many cases, but for PCL only few cases have been reported in English literature. Terms and Conditions, Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. Level of evidence: Mucoid degeneration of ACL is a disease affecting ACL in which mucoid like substance (glycosaminoglycans) gets interspersed within the substance of ACL and as a result ACL gets thickened. MM and A performed the literature search, and data analysis. The .gov means its official. Epub 2013 Aug 27. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. https://doi.org/10.1016/j.jclinepi.2009.06.005. Hypothesis: 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. Khanna et al. J Bone Joint Surg Ser B 81(2):304305. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Federal government websites often end in .gov or .mil. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . 2001;30(6):312315. Epub 2010 May 8. https://doi.org/10.4103/0019-5413.128765, Article Indian J Orthop 46(5):561565. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. The retrospective study by Kim et al. https://doi.org/10.2214/ajr.182.5.1821283, Article Mucoid cystic degeneration of the cruciate ligament. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. This site needs JavaScript to work properly. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Sep 2017 - Feb 20186 months. Only nine studies met our inclusion criteria and they were all case series. Indian J Orthop 48(2):197202. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. ANZ J Surg 73(9):712716. eCollection 2013. The knee is a complex synovial joint that can be affected by a range of pathologies: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. This bicentric, retrospective cohort study with an average follow-up of 6years involved 27 patients (29 knees) presenting with symptomatic ACL mucoid degeneration validated by magnetic resonance imaging (MRI). 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. See this image and copyright information in PMC. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. AJR Am J Roentgenol. Epub 2021 Nov 24. Morice et al. Clin Orthop Surg. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. Knee Surg Sports Traumatol Arthrosc. Introduction: Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. This systematic review has some limitations. GG and AM interpreted the results and reviewed the manuscript. 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. PubMedGoogle Scholar. -, Fealy S, Kenter K, Dines JS, Warren RF. 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. Advanced MR imaging of the cruciate ligaments. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Physical therapy typically begins 7-10 days after the procedure. Provided by the Springer Nature SharedIt content-sharing initiative. In most cases Physiopedia articles are a secondary source and so should not be used as references. J Bone Joint Surg Br. Please enable it to take advantage of the complete set of features! Three reviewers (an experienced librarian and two of the authors) independently searched these databases. HHS Vulnerability Disclosure, Help Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. and transmitted securely. Hide glossary Glossary. -. eCollection 2022 May-Jun. Initially, partial weightbearing is allowed. 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 . Mucoid degeneration of ACL. Physiotherapy. The clinical presentation is one of posterior pain with limited flexion. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Epub 2018 Jan 2. Keywords: Clipboard, Search History, and several other advanced features are temporarily unavailable. California Privacy Statement, government site. and Ventura et al. Arthroscopic debridement may help relieve the anterior knee pain. . The origin of MDACL may be degenerative or traumatic. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Epub 2008 Apr 18. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Characteristic: "celery stalk" appearance. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. government site. Its signal is increased on all sequences. 2007;90(3):1923. I get PT and acupuncture, have had several epidural injections, and am trying hard to avoid osteoporosis meds (was on bisphosphonates for many years many years ago) as well as spinal fusion. Skeletal Radiology. 1. Fourteen knees (48%) had limited flexion, on average 97 degrees. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Despite the low rate of complications in all studies, there was a high incidence of postoperative knee laxity, demonstrated by a positive Lachman test, in most studies. 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 cruciate ligament, improving patient satisfaction and function without causing clinical instability in daily activities. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. However, MDACL is asymptomatic in most patients. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT 2,375 views Sep 15, 2019 23 Dislike Dr. Prateek Joshi- Ortho 1.02K subscribers Notice Age-restricted video (based on Community Guidelines). sharing sensitive information, make sure youre on a federal Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. Online ahead of print. This was lowest in the study of Cha et al. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. A total of nine studies were eligible for review. 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). Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Arthroscopy. (A) Bulging of the hypertrophied anterior cruciate ligament. 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. 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. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Before Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid 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. It is a chronic degenerative change of a bulky ACL that may lead to notch . Accessibility Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. 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. Accessed 1 Mar 2021. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review, https://doi.org/10.1186/s43019-021-00110-6, https://doi.org/10.1302/0301-620X.81B2.0810304, https://doi.org/10.1007/s00167-011-1433-0, https://doi.org/10.2214/ajr.182.5.1821283, https://doi.org/10.1007/s00167-012-1991-9, https://doi.org/10.1016/j.arthro.2003.11.030, https://doi.org/10.1016/j.jclinepi.2009.06.005, http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782, https://doi.org/10.1046/j.1445-2197.2003.02748.x, http://journals.sagepub.com/doi/10.1177/2325967118786930, http://www.ijcrar.com/abstractview.php?ID=228&vol=4-11-2016&SNo=3, https://doi.org/10.1016/j.arthro.2008.02.004, https://doi.org/10.1016/j.jajs.2015.12.001, https://doi.org/10.4055/cios.2018.10.3.307, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/.
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