J Sports Med Phys Fitness 48(4):483487, PubMed Epub 2013 Aug 27. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. There was more than 20% loss to follow up in the study of Kim et al., while the three prospective studies had no loss to follow up [13, 14, 18]. had the largest number of patients (91) with a mean age of 61 years, which was the oldest study population amongst the nine studies [16]. 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. How is mucoid degeneration treated? - Sdnimik.bluejeanblues.net 2011. Careers. The inclusion criteria for this study were (1) studies including symptomatic patients with mucoid degeneration of the ACL, (2) studies of 10 or more patients, (3) a minimum of 6months follow up and (4) patients treated conservatively or surgically (arthroscopic debridement with or without simultaneous ACL reconstruction). 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). 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. In the nine included studies, four different scores were used for outcome assessment. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Radiofrequency Ablation for Mucoid Degeneration of the Anterior Clinical outcome was reported using a variety of scores (the Lysholm and International Knee Documentation Committee (IKDC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the visual analogue scale (VAS) score) in the different studies; these are summarized in Table 4. Online ahead of print. Symptoms included limited range of motion (ROM) and posterior knee pain. Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons. Seventeen females (67%) and eight males (33%) were included in the final analysis. Ligaments are very tough, fibrous tissue structures. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. J Bone Joint Surg Br. The https:// ensures that you are connecting to the Accessed 1 Mar 2021. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. 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. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Pan African Medical Journal. Anatomopathology samples were collected in 18 cases. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. 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. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. J Orthop. J Orthop. Any discrepancy was resolved by the senior author. Epub 2018 Jun 13. Indian J Orthop. Mumbai, Maharashtra, India. CAS Ventura et al. HHS Vulnerability Disclosure, Help 2007;15 (1): 73-86. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Privacy -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Case report: intra-tendinous ganglion of the anterior cruciate ligament : A Meta-Analysis. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. Orthopaedics & Traumatology: Surgery & Research. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . The total number of patients with symptomatic instability was 18 out of 288 (6%). This systematic review has some limitations. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. 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. All patients (100%, n=11) reported a good to very good surgery satisfaction. 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. Arthroscopic management of mucoid degeneration of anterior cru When refering to evidence in academic writing, you should always try to reference the primary (original) source. 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 anterior cruciate ligament (ACL ). 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Postoperative pain relief was reported in seven studies. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. https://doi.org/10.2214/ajr.182.5.1821283, Article https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. what causes mucoid degeneration of acl. MM and A performed the literature search, and data analysis. A systematic literature search in the databases MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus was performed through July 2020 by three independent reviewers. PDF Mucoid degenerated anterior cruciate ligament managed by arthroscopic 6. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. A total of nine studies were eligible for review. AJR Am J Roentgenol. Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. The https:// ensures that you are connecting to the Arthroscopic debridement may help relieve the anterior knee pain. 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. 1). 2012;4 (2): 167-70. Rehabilitation, orthophony, crenotherapy. CIOS :: Clinics in Orthopedic Surgery Case report: Radiology. 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. Bethesda, MD 20894, Web Policies Introduction: official website and that any information you provide is encrypted Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Sweed, T., Mussa, M., El-Bakoury, A. et al. The mean MINORS score was 9.5 (range 412). Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 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. They respond well to a judicious arthroscopic release of the ACL with notchplasty. The mean follow up ranged from 13 to 72months. -, Fealy S, Kenter K, Dines JS, Warren RF. International Journal of Orthopaedics. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms Furthermore, this raises the question as to whether the symptoms (pain and diminished range of movement) were solely due to MDACL and not secondary to other associated pathological conditions. The clinical presentation is one of posterior pain with limited flexion. 2011. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Postoperative symptomatic instability was not common in eight studies, but was observed in 48% of patients in the study of Lintz et al., with two patients having a delayed ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. (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). 2007;245 (3): 916-7. An official website of the United States government. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Khanna et al. Anterior Cruciate Ligament (ACL) Mucoid Degeneration - Physiopedia 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Mucoid cystic degeneration of the cruciate ligament. Therefore, indications for ACL resection must be carefully selected. 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 ]. What is acl mucoid degeneration? | HealthTap Online Doctor Other theories include Degenerative theory- MD could occur due to ageing.[3]. mucoid degeneration of acl mri. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. 8600 Rockville Pike 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Federal government websites often end in .gov or .mil. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . National Center for Biotechnology Information Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. 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. What does mucoid degeneration of posterior horn of medial - HealthTap Arthroscopy. 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). Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. HHS Vulnerability Disclosure, Help Kwee RM, Hafezi-Nejad N, Roemer FW, Zikria BA, Hunter DJ, Guermazi A, Demehri S. Association of Mucoid Degeneration of the Anterior Cruciate Ligament at MR Imaging with Medial Tibiofemoral Osteoarthritis Progression at Radiography: Data from the Osteoarthritis Initiative. All nine studies were case series; six were retrospective and three were prospective studies. HHS Vulnerability Disclosure, Help Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. However, MDACL is asymptomatic in most patients. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. No reconstruction was performed at the same time. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Provided by the Springer Nature SharedIt content-sharing initiative. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). See this image and copyright information in PMC. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. 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. National Library of Medicine 2011 Mar;25(3):262-5. An official website of the United States government. https://www.physio-pedia.com/index.php?title=Anterior_Cruciate_Ligament_(ACL)_Mucoid_Degeneration&oldid=253974, Difficulty in climbing stairs, cross-leg sitting, squatting, Primary condition- Osteoarthritis, degenerative menisci, meniscal tear, Impingement of the soft tissue in the vicinity. W B Saunders Co. (2005) ISBN:0721602703. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. 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. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Method. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Postoperative clinical laxity was common, however, symptomatic instability was not. The site is secure. 2. KoreaMed Synapse It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. An official website of the United States government. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Results: In most cases Physiopedia articles are a secondary source and so should not be used as references. Level of Evidence: Level IV. Federal government websites often end in .gov or .mil. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. 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. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. Arthroscopy. Indian J Orthop 48(2):197202. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. PubMed Central However, the authors did not report whether there were any other patients with symptomatic instability. MAUDE Adverse Event Report: GENZYME BIOSURGERY (RIDGEFIELD) SYNVISC ONE Each study was scored 02 on each question, with a global ideal score of 16. report that one patient had ACL reconstruction simultaneously after the ACL debridement. 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. Ligaments and tendons are accumulated by mucoid change might display a thickened and/or hypertrophied appearance, with an increase in signal intensity. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42018087782). Epub 2008 Dec 17. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity that has been found in patients with pain and limited range of motion of the knee in association with a bulky ACL shown on magnetic resonance imaging (MRI). Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Physical therapy typically begins 7-10 days after the procedure. 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. PubMed Clinical significance of T2*-weighted gradient-echo MRI to monitor On clinical examination, the active range of motion showed a flexion deficit. (2018) Radiology. Mucoid degeneration of ACL | Mayo Clinic Connect Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. It results in postoperative laxity, but rarely in frank instability. bling. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. 5. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. The author(s) read and approved the final manuscript. 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. Disclaimer. Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. Unable to load your collection due to an error, Unable to load your delegates due to an error. Anterior cruciate ligament mucoid degeneration: Selecting the best Methods From January 2012 to August 2013, 32 knees (24 females and 8 males with left knee of 14 and 18 of right) were diagnosed with mucoid degeneration of the ACL and underwent arthroscopic treatment, all of whom with a mean age of 58.817.97 years (42-74 years). Arch Orthop Trauma Surg. 2 ). Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a 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 anterior cruciate ligament (ACL). Four studies reported only postoperative scores, which were comparable to those in other studies. 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. Knee Surg Sports Traumatol Arthrosc 21(3):658663. 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 . There was a high rate of association between degenerative lesions and MDACL, ranging from 39 to 96%. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate mucoid degeneration of acl - Best Orthopedic doctor in Jaipur Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. 2011;19(3):408411. Online ahead of print. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. 2001;30(6):312315. The minimum follow-up was 3 years. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). Anterior cruciate ligament mucoid degeneration: selecting the best reported the largest percentage of patients (27.5%) with a positive pivot test. 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). Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. All rights reserved. Mucoid degeneration of the anterior cruciate ligament. [PDF] Mucoid degeneration of the anterior cruciate Ligament: a case https://doi.org/10.1016/j.arthro.2008.02.004, Morice A, Coupry A, Lintz F, Robert H (2013) Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. 1. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-3615, Case 11: with Hoffa fat pad ganglion cyst, Case 12: tibial nerve schwannoma and ACL mucoid degeneration, Case 1: Complete ACL tear and meniscal tears, Case 2: Anomalous insertion of the medial meniscus, View Frank Gaillard's current disclosures, see full revision history and disclosures, anterior cruciate ligament ganglion cysts, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Mucoid degeneration of the anterior cruciate ligament, congenital or acquired synovial tissue entrapment between ACL fibers. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report The anterior cruciate ligament (ACL) is an important ligament in the knee. 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. PMC eCollection 2021. Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). 4. Careers. Please enable it to take advantage of the complete set of features! proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. The .gov means its official. The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. Bookshelf Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra Preoperative magnetic resonance imaging (MRI) scan. https://doi.org/10.4103/0019-5413.101037, Srivastava A, Pateliya S, Singh H, Aggarwal S, Srivastava S (2016) Mucoid degeneration of anterior cruciate ligament management and functional outcome of 18 cases. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. None of the studies was a randomised controlled trial and none had a control group. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. Unable to process the form. Int J Curr Res Aca Rev 4(11):1824 http://www.ijcrar.com/abstractview.php?ID=228&vol=4-11-2016&SNo=3, Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI (2008) Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Epub 2018 Apr 21. The extracted data were assessed for meta-analysis. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT - YouTube
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