volume33, Articlenumber:26 (2021) The extracted data were heterogeneous in terms of outcome assessment. 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 ]. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Epub 2010 May 8. Anterior cruciate ligament mucoid degeneration. 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. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. 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. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. 2006;69(9):44952. 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). Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Its function is to stabilize the knee while bending and rotating; the ACL also keeps the knee from shifting out of place or moving anteriorly (toward the front) with pivoting activities. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. FOIA Anatomopathology samples were collected in 18 cases. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. Level of evidence: [18] did not comment on an association between MDACL and chondral or meniscal lesions: after the exclusion of that report, the total number of patients with associated chondral lesions was 226 out of 275 patients (82%) and 190 patients had meniscal lesions (69%). Clipboard, Search History, and several other advanced features are temporarily unavailable. Rehabilitation, orthophony, crenotherapy. sharing sensitive information, make sure youre on a federal Arthroscopy. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 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. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Before The mean age of patients ranged from 31 to 78years. official website and that any information you provide is encrypted Mucoid degeneration of the anterior cruciate ligament. The presence of intraligamentous mucoid degeneration in the ACL is demonstrated as a source of knee pain without instability and partial ACL debridement did not preclude adequate knee stability. -, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK. Preoperative and postoperative results of eleven patient were compared. The site is secure. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Part of A long duration of non-specific knee pain in a patient should be evaluated with MRI. Risk factors Predisposing factors include the following 1: aging Background: Before Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Average patient age was 49 (22 to 68) years. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. Orthop Traumatol Surg Res. Besides, the patient may also have trouble in moving. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. mucoid degeneration of acl mri. J Clin Epidemiol 62(10):10061012. Arthroscopy. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 2011. Physiotherapy. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Questions just answered: mucoid degeneration of acl physiotherapy. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Four studies reported only postoperative scores, which were comparable to those in other studies. 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. government site. All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Methods: Epub 2013 Aug 27. Bookshelf PROSPERO. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. Generally, we know little about this condition. government site. 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. Would you like email updates of new search results? 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. Preoperative magnetic resonance imaging (MRI), Fig. 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. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. AJR Am J Roentgenol. bling. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. See this image and copyright information in PMC. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. Copyright 2010 Elsevier Masson SAS. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. 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 . Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. A total of 313 knees in 292 patients were included. . -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. 8600 Rockville Pike National Library of Medicine 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 2011 Jun;25(6):650-2. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. There was strong association between degenerative changes and MDACL (82% having chondral and 69% meniscal lesions), which might suggest that MDACL is a degenerative process. (Table 3). Anterior Cruciate Ligament, is an important structure of the knee joint. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Resnick D, Kransdorf MJ. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Sagittal T2-weighted MRI view showing intact anterior, Fig. 2011 Aug 1;19(8):1326-33. Before The ligament is mainly responsible for restraining anterior translation of knee. Two patients uderwent secondary ligamentoplasty. 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. 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 . 1). I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. This systematic review has some limitations. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. 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. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Radiology. Roberts CC, Towers JD, Spangehl MJ et-al. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. The site is secure. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. The .gov means its official. PubMedGoogle Scholar. Introduction: Epub 2008 Apr 18. National Library of Medicine Accessed 1 Mar 2021. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). FOIA Unauthorized use of these marks is strictly prohibited. 2011 Mar;25(3):262-5. 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). 5. PubMed Central An official website of the United States government. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Correspondence to Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Rehabilitation, speech therapy, crenotherapy. MM and A performed the literature search, and data analysis. FOIA Bethesda, MD 20894, Web Policies Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. Cho SD, Youm YS, Lee CC et-al. 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. There is no consensus on treatment and evidence is scarce. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2010 Jun 1;96(4):400-6. 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. ACL tears don't heal as such. Epub 2021 Mar 8. AJR Am J Roentgenol. This may support the theory that it is a degenerative process. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Federal government websites often end in .gov or .mil. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. PMC Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. 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. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). 1. Tamer Sweed. 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]. Arthroscopy 20(2):141146. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Orthopedics; anterior cruciate ligament; arthoscopy. Epub 2018 Jun 13. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. Multiple theories have been put forth that explains the pathological disorganization in the collagen fibers of the Anterior Cruciate Ligament, such as synovial, traumatic, and degenerative, "Synovial theory- states that there is accumulation of synovial fluid inside the substance of ACL in a herniated pouch of synovium. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. The .gov means its official. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Chudasama CH, Chudasama VC, Prabhakar MM. eCollection 2021. The aetiology of MDACL is not clearly understood. This is basically an MRI diagnosis of expansion and increased signal of an intact ACL in a person with knee pain which is worse on knee flexion/bending. This site needs JavaScript to work properly. Bethesda, MD 20894, Web Policies official website and that any information you provide is encrypted Careers. This study concerns complete ACL resec {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. PubMed 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). There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. in 1999 [ 1 ]. Skeletal Radiol. Arthroscopy. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Mucoid degeneration of the anterior cruciate ligament. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Online ahead of print. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a well-recognized pathology characterized by the degradation of collagen fibers and infiltration of a mucoidlike substance, [1,2 . 3. The rate of simultaneous meniscectomy ranged from 13 to 44%. However, MDACL is asymptomatic in most patients. Indian J Orthop 48(2):197202. Knee Surg Sports Traumatol Arthrosc 21(3):658663. Symptoms included limited range of motion (ROM) and posterior knee pain. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. official website and that any information you provide is encrypted Bethesda, MD 20894, Web Policies Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. [Diagnosis and treatment of anterior cruciate ligament cysts]. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. The quality of methodology was excellent in one study, good in five studies, low in two studies and very low in one study (Tables 1 and 2). 2. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Reeducation. Reeducation. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. official website and that any information you provide is encrypted Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. Results: Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 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). Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. The clinical presentation is one of posterior pain with limited flexion. Online ahead of print. Khanna et al. 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. 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. All patients (100%, n=11) reported a good to very good surgery satisfaction. Later studies reported that changes consist of mucoid Results degeneration, neovascularisation, and tendon sheath hyper- Nineteen patients met the inclusion criteria and were inclu- trophy. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. J Orthop. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Individuals with mucoid degeneration of the ACL were excluded. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. Clin Orthop Surg. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Patients and methods: Orthop Traumatol Surg Res. Postoperative pain relief ranged from 53.8 to 95%. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms W B Saunders Co. (2005) ISBN:0721602703. The site is secure. Along with that, it also controls the internal rotation. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Mucoid degeneration of the anterior cruciate ligament. proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. -, Hodler J, Haghighi P, Trudell D, Resnick D. The cruciate ligaments of the knee: Correlation between MR appearance and gross and histologic findings in cadaveric specimens. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. 2007;245 (3): 916-7. GG and AM interpreted the results and reviewed the manuscript. No treatment is usually required. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. 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. Check for errors and try again. Glossary of terms for musculoskeletal radiology. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. Physiotherapy. Bookshelf Symptomatic ACL mucoid degeneration in middle-age athletes. What Is Mucoid Degeneration of the ACL? 1. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. They respond well to a judicious arthroscopic release of the ACL with notchplasty. Pan African Medical Journal. Magn Reson Imaging Clin N Am. Bookshelf Chudasama et al. J Bone Joint Surg Ser B 81(2):304305. An official website of the United States government. ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. The purpose of this study was to investigate the outcome of management of MDACL by performing a systematic review of methods of treatment that have been reported. Arthroscopy. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Sep 2017 - Feb 20186 months. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. eCollection 2013. reported on the co-existence of mucoid degeneration and ganglia of the ACL. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Careers. 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. What is Anterior Cruciate Ligament Mucoid Degeneration? Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. This site needs JavaScript to work properly. Arch Orthop Trauma Surg. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Cookies policy. The appearance can mimic acute or chronic interstitial partial tears of the ACL.
Do Lanterns Stop Mobs From Spawning,
Articles M