The minimum follow-up was 3 years. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. 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. Epub 2018 Jun 13. Symptomatic instability was highest in the study of Lintz et al. The anterior cruciate ligament (ACL) is an important ligament in the knee. Mucoid degeneration of the anterior cruciate ligament (ACL) is regarded as a degenerative change in the ligament, which is clinically presented with pain on full extension or flexion in the middle-aged population. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Epub 2021 Mar 8. Bookshelf This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Morice et al. 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. [16]. TS designed the project, literature search and wrote the manuscript. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 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. Arch Orthop Trauma Surg. sharing sensitive information, make sure youre on a federal 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. PROSPERO. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. 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. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Introduction: It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. Questions just answered: mucoid degeneration of acl physiotherapy. MeSH 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. Accessibility A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. and transmitted securely. ACL Ganglion Cysts - Radsource A total of 313 knees in 292 patients were included in the nine studies. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. https://doi.org/10.1007/s00167-011-1433-0, Article 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). Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT - YouTube 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. 2006;69(9):44952. Unable to load your collection due to an error, Unable to load your delegates due to an error. We report a case of a patient with mucoid degeneration of the ACL, presenting with posterior knee pain and no history of a major knee trauma. The site is secure. 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. 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. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. https://doi.org/10.4055/cios.2018.10.3.307, University Hospitals of Derby and Burton, Uttoxeter Rd, Derby, DE22 3NE, UK, Trauma and Orthopaedic Speciality Trainee, West Midlands Deanery, Birmingham Rotation, Birmingham, UK, University Hospitals Plymouth NHS Trust, Plymouth, UK, University of Alexandria, Alexandria, Egypt, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry, CV2 2DX, UK, You can also search for this author in Read More Created for people with ongoing healthcare needs but benefits everyone. Before There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. 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 . This site needs JavaScript to work properly. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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]. 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). eCollection 2021. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. Epub 2010 May 8. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. Mucoid degeneration of both ACL and PCL. Symptoms included limited range of motion (ROM) and posterior knee pain. You can read more if you want. Would you like email updates of new search results? Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Fourteen knees (48%) had limited flexion, on average 97 degrees. Resnick D, Kransdorf MJ. The mean MINORS score was 9.5 (range 412). Preoperative magnetic resonance imaging (MRI), Fig. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. MM and A performed the literature search, and data analysis. 2. Careers. MeSH Federal government websites often end in .gov or .mil. Postoperative recovery was four weeks on average. 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. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. Rehabilitation, speech therapy, crenotherapy. Four studies reported only postoperative scores, which were comparable to those in other studies. What causes mucoid degeneration of ACL? These appearances must be differentiated from mucoid degeneration of the intact ACL. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Hypothesis: 8600 Rockville Pike The aetiology of MDACL is not clearly understood. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Mucoid degeneration of ACL. The .gov means its official. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. This study concerns complete ACL resec Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Disclaimer. Knee Surgery & Related Research and Ventura et al. 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. Clin Orthop Surg 10(3):307314. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. KoreaMed Synapse 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 Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. sharing sensitive information, make sure youre on a federal Epub 2011 Feb 18. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. The total number of patients with symptomatic instability was 18 out of 288 (6%). [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%). Mucoid cystic degeneration of the cruciate ligament. Conclusions. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. 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. FOIA The mean age at the time of surgery was 57 years (range, 31 to 78 years). Bethesda, MD 20894, Web Policies PDF Mucoid degenerated anterior cruciate ligament managed by arthroscopic Average improvement in flexion was 21.5 degrees (0 to 60 degrees). and transmitted securely. 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 ]. https://doi.org/10.1016/j.jclinepi.2009.06.005. Arthroscopy. Cite this article. Ventura et al. Risk factors Predisposing factors include the following 1: aging The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. International Journal of Orthopaedics. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. official website and that any information you provide is encrypted 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. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. A total of 313 knees in 292 patients were included. Epub 2013 Aug 27. However, the authors did not report whether there were any other patients with symptomatic instability. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. . Intact fibers are best seen on T2WI. AJR Am J Roentgenol. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Rehabilitation, orthophony, crenotherapy. reported the largest percentage of patients (27.5%) with a positive pivot test. Would you like email updates of new search results? Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Before A long duration of non-specific knee pain in a patient should be evaluated with MRI. Anterior cruciate ligament mucoid degeneration - Radiopaedia Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. 2012;4 (2): 167-70. 2010 Jun 1;96(4):400-6. The ligament is mainly responsible for restraining anterior translation of knee. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. 8600 Rockville Pike 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 . HHS Vulnerability Disclosure, Help Epub 2010 May 8. ANZ J Surg 73(9):712716. 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. 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. Postoperative clinical laxity was common, however, symptomatic instability was not. Arthroscopy. 2009. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. 2008;24(6):642649. Conclusion: Clipboard, Search History, and several other advanced features are temporarily unavailable. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. 2023 BioMed Central Ltd unless otherwise stated. Bergin D, Morrison WB, Carrino JA et-al. Knee Surg Sports Traumatol Arthrosc. Arch Orthop Trauma Surg. Indian J Orthop. 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). Mucoid degeneration of the anterior cruciate ligament. AJR Am J Roentgenol. government site. Postoperative pain relief ranged from 53.8 to 95%. Physical therapy typically begins 7-10 days after the procedure. Magnetic Resonance Imaging is the most useful tool for differentiating mucoid degeneration of the ACL from an intraligamentous ganglion or other lesions in the knee joint and if this disease is considered preoperatively, it can be diagnosed easily based on characteristic findings. None of the studies was a randomised controlled trial and none had a control group. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. Pan African Medical Journal. official website and that any information you provide is encrypted 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. PMC 2011. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. National Library of Medicine We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. W B Saunders Co. (2005) ISBN:0721602703. Glossary of terms for musculoskeletal radiology. Knee. PubMed All nine studies were case series; six were retrospective and three were prospective studies. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. Disclaimer. Average patient age was 49 (22 to 68) years. 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. Orthop Traumatol Surg Res. 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. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Instrumental treatment. -. Symptomatic ACL mucoid degeneration in middle-age athletes. 2001;17(9):E37. 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.). Preoperative and postoperative results of eleven patient were compared. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. 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. Bethesda, MD 20894, Web Policies The https:// ensures that you are connecting to the [Diagnosis and treatment of anterior cruciate ligament cysts]. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. Patients and methods: 2007;245 (3): 916-7. to 44% in the study of Cha et al. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. Mucoid degeneration of the anterior cruciate ligament. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. 1. CAS The appearance can mimic acute or chronic interstitial partial tears of the ACL. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. J Arthrosc Joint Surg 3(1):2833. They respond well to a judicious arthroscopic release of the ACL with notchplasty. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Mucoid degeneration of ACL - Osteoporosis - inspire.com 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]. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Arthroscopic findings. https://doi.org/10.2214/ajr.182.5.1821283, Article Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Epub 2013 Aug 27. Unauthorized use of these marks is strictly prohibited. : A Meta-Analysis. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. The https:// ensures that you are connecting to the This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). 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. Careers. Pain was posterior in 23 knees (80%). Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. What you feel (symptoms) You feel heaviness in knee joint. Arch Orthop Trauma Surg. National Center for Biotechnology Information -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. Categories were determined in accordance with the study of Ekhtiari et al. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Fort Sam Houston Ait Graduation Dates 2022, How To Remove Embroidery From A Carhartt Jacket, Articles M
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