2011. 8600 Rockville Pike Anterior Cruciate Ligament, is an important structure of the knee joint. It is a chronic degenerative change of a bulky ACL that may lead to notch . Bethesda, MD 20894, Web Policies 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. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Please enable it to take advantage of the complete set of features! In the nine included studies, four different scores were used for outcome assessment. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, most pronounced at 6-7 and small disc herniations at 5-6 and C4-5, with slight interval progression at 5-6. . https://doi.org/10.4103/0019-5413.128765, Article FOIA Springer Nature. For non-comparative studies, this consists of eight questions. J Orthop. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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. Four studies reported only postoperative scores, which were comparable to those in other studies. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. CAS Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. 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. Pandey, Vivek et al. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. An anterior cruciate ligament (ACL) mucoid degeneration, along with tears and anterior cruciate ligament ganglion cysts, is a relatively common cause of increased signal within the. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. See this image and copyright information in PMC. Mucoid cystic degeneration of the cruciate ligament. National Library of Medicine Chudasama et al. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. Physiotherapy. Online ahead of print. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. Knee Surg Sports Traumatol Arthrosc. This may support the theory that it is a degenerative process. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Knee. in this condition your acl (anterior cruciate ligament) filled with jelly like material and it thickened so space in intercondylar resion of knee joint is reduced. In six of the nine studies [6, 14, 16,17,18], arthroscopic debridement of the ACL was associated with simultaneous partial meniscectomy; this ranged from 13% in the study of Morice et al. Noninfiltrating synovial cysts of the ACL were excluded. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH AJR Am J Roentgenol. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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). 2023 BioMed Central Ltd unless otherwise stated. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Orthopaedics & Traumatology: Surgery & Research. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. The .gov means its official. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. GG and AM interpreted the results and reviewed the manuscript. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. 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). Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Careers. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee 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. Epub 2011 Feb 18. There was strong association with chondral lesions and meniscal tears. 3. The minimum follow-up was 3 years. Tamer Sweed. Arthroscopy. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. 2012;4 (2): 167-70. What is myxoid degeneration treatment? Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. The mean MINORS score was 9.5 (range 412). . 1. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. Bone and joint imaging. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) 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]. The https:// ensures that you are connecting to the 8600 Rockville Pike In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. -, Fealy S, Kenter K, Dines JS, Warren RF. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. 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. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Knee Surg Sports Traumatol Arthrosc. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Would you like email updates of new search results? This systematic review has some limitations. In the Lintz study, total resection of the ACL was performed in 17 out of 29 knees, while in the Ventura study total resection was performed in 17 out of 25 patients. Careers. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 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. The aetiology of MDACL is not clearly understood. https://doi.org/10.2214/ajr.182.5.1821283, Article Roberts CC, Towers JD, Spangehl MJ et-al. Glossary of terms for musculoskeletal radiology. Average patient age was 49 (22 to 68) years. None of the studies was a randomised controlled trial and none had a control group. 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. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. 2. 2009. 2001;30(6):312315. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. The total number of patients with symptomatic instability was 18 out of 288 (6%). Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Bookshelf PubMed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. and transmitted securely. 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. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. 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). Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid 2018;4(4):875-80. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Unauthorized use of these marks is strictly prohibited. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. 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. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. 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). Skeletal Radiol. Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon non-traumatic cause of knee pain and motion restriction, typically seen in a middle-aged population. sharing sensitive information, make sure youre on a federal What is Anterior Cruciate Ligament Mucoid Degeneration? Keywords: Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. See this image and copyright information in PMC. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). Postoperative recovery was four weeks on average. Unable to load your collection due to an error, Unable to load your delegates due to an error. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. 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. Federal government websites often end in .gov or .mil. 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. The mean MINORS score was 9.5 out of 16 (412). Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. Epub 2018 Apr 21. Clin Orthop Surg. J Arthrosc Joint Surg 3(1):2833. Clin Orthop Surg. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. 2. Accessibility Bergin et al. 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. All patients (100%, n=11) reported an improvement in pain. Patients will . Before Mucoid degeneration of the ACL is a rare cause of knee pain.1-8) This lesion of the ACL was first reported by Kumar et al.3) in 1999. Epub 2011 Feb 18. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. Please enable it to take advantage of the complete set of features! The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2011 Jun;25(6):650-2. Knee Surg Sports Traumatol Arthrosc 21(3):658663. Symptomatic ACL mucoid degeneration in middle-age athletes. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic 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]. (B) Partial resection, MeSH Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Reeducation. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. . The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Each study was scored 02 on each question, with a global ideal score of 16. in 1999 [1]. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Would you like email updates of new search results? 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. The origin of MDACL may be degenerative or traumatic. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate government site. FOIA Manage cookies/Do not sell my data we use in the preference centre. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Arthroscopic findings. 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. 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. Imaging: Plain radiographs Before Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. Please enable it to take advantage of the complete set of features! 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). Keywords: [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. government site. (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).

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