Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Unauthorized use of these marks is strictly prohibited. Conditions that resembles the clinical findings are: Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. ACL debridement was partial in all studies except for those by Lintz et al. Only nine studies met our inclusion criteria and they were all case series. 2. Its signal is increased on all sequences. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. 1999;81(2):304305. 2018. http://journals.sagepub.com/doi/10.1177/2325967118786930, Pandey V, Suman C, Sharma S, Rao SP, Kiran Acharya K, Sambaji C (2014) Mucoid degeneration of the anterior cruciate ligament: management and outcome. ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. and transmitted securely. https://doi.org/10.4103/0019-5413.128765, Article Bethesda, MD 20894, Web Policies A total of 313 knees in 292 patients were included in the nine studies. 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. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Conclusions: Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. 1. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Symptomatic ACL mucoid degeneration in middle-age athletes. National Library of Medicine What Is Mucoid Degeneration of the ACL? Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. 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 No reconstruction was performed at the same time. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. 2011 Aug 1;19(8):1326-33. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. Bergin et al. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. https://doi.org/10.1016/j.jclinepi.2009.06.005. Cookies policy. 2011. Symptomatic ACL mucoid degeneration in middle-age athletes. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. ADVERTISEMENT: Supporters see fewer/no ads. Read More Created for people with ongoing healthcare needs but benefits everyone. PMC Careers. Epub 2011 Feb 18. Bethesda, MD 20894, Web Policies Introduction: Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Hide glossary Glossary. Mucoid degeneration of the anterior cruciate ligament: a case report. 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). 2010 Jun 1;96(4):400-6. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 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. . The mean follow up ranged from 13 to 72months. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. . 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. 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. Epub 2010 May 8. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. 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). This may support the theory that it is a degenerative process. 1). J Chin Med Assoc. 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. The .gov means its official. Accessibility All nine studies assessed the outcome of arthroscopic debridement of MDACL. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. PubMedGoogle Scholar. This site needs JavaScript to work properly. Skelet Radiol 30(6):312315. All nine studies were case series; six were retrospective and three were prospective studies. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Sagittal T2-weighted MRI view showing intact anterior, Fig. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. You can read more if you want. The retrospective study by Kim et al. (2018) Radiology. It can cause pain and to a meniscal tear. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). J Orthop. The authors declare that they have no competing interests. Partial/Total ACL resection arthroscopically- There is marked improvement in the range and reduced posterior pain, but at the cost of increased post-operative knee laxity. Clipboard, Search History, and several other advanced features are temporarily unavailable. In most cases Physiopedia articles are a secondary source and so should not be used as references. Introduction: Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. 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. Skeletal Radiol. Characteristic: "celery stalk" appearance. The site is secure. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. in 1999 [ 1 ]. Imaging: Plain radiographs 2008;24(6):642649. Therefore, indications for ACL resection must be carefully selected. 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. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. did not report on this. 2004;182(5):12831287. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. 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. 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. Please enable it to take advantage of the complete set of features! Instrumental treatment. The mean MINORS score was 9.5 (range 412). FOIA Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. None of the studies was a randomised controlled trial and none had a control group. TS designed the project, literature search and wrote the manuscript. The mean age at the time of surgery was 57 years (range, 31 to 78 years). The https:// ensures that you are connecting to the Bethesda, MD 20894, Web Policies Hypothesis: 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. 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. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Khanna et al. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. FOIA Knee Surg Sports Traumatol Arthrosc. 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. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. FOIA Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. . The mean follow up ranged from 13 to 72months. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Arthroscopic findings. Cite this article. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Ventura et al. 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. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. JBR-BTR. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. and Ventura et al. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Mucoid cystic degeneration of the cruciate ligament. Arch Orthop Trauma Surg. 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. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. There was strong association with chondral lesions and meniscal tears. 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. 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 of mucoid hypertrophy of the anterior cruciate ligament. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. volume33, Articlenumber:26 (2021) 2011 Jun;25(6):650-2. GG and AM interpreted the results and reviewed the manuscript. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. ACL tears don't heal as such. Orthopaedics & Traumatology: Surgery & Research. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. official website and that any information you provide is encrypted All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. mucoid degeneration of acl mri. Along with that, it also controls the internal rotation. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Learn how we can help 704 views Reviewed >2 years ago Thank 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. The origin of MDACL may be degenerative or traumatic. Therefore, indications for ACL resection must be carefully selected. 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 . First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). 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. official website and that any information you provide is encrypted MeSH 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]. The anterior cruciate ligament (ACL) is an important ligament in the knee. 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. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Mumbai, Maharashtra, India. It results in postoperative laxity, but rarely in frank instability. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. Indian J Orthop. An official website of the United States government. 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. eCollection 2022 May-Jun. Bergin D, Morrison WB, Carrino JA et-al. Average patient age was 49 (22 to 68) years. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Would you like email updates of new search results? Rehabilitation, speech therapy, crenotherapy. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. eCollection 2021. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. This systematic review has some limitations. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. 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. and transmitted securely. This site needs JavaScript to work properly. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. MeSH This bicentric, retrospective cohort study with an average follow-up of 6years involved 27 patients (29 knees) presenting with symptomatic ACL mucoid degeneration validated by magnetic resonance imaging (MRI). Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. 5. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. Before official website and that any information you provide is encrypted Federal government websites often end in .gov or .mil. Level of evidence: Truncation means that the . Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. J Bone Joint Surg Br. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. By using this website, you agree to our Eight studies reported postoperative instability. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Symptoms included limited range of motion (ROM) and posterior knee pain. Method. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Epub 2018 Aug 22. and transmitted securely. https://doi.org/10.1007/s00167-012-1991-9, McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. (100%). Epub 2018 Apr 21. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. 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. On clinical examination, the active range of motion showed a flexion deficit. Would you like email updates of new search results? 2004;182 (5): 1283-7. (B) Partial resection, MeSH 8600 Rockville Pike Resnick D, Kransdorf MJ. 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. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). 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 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. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. 1. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. 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. J Clin Epidemiol 62(10):10061012. Ligaments and tendons are accumulated by mucoid change might display a thickened and/or hypertrophied appearance, with an increase in signal intensity. Seventeen females (67%) and eight males (33%) were included in the final analysis. Arthroscopy. Disclaimer. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. What you feel (symptoms) You feel heaviness in knee joint. The clinical presentation is one of posterior pain with limited flexion. (A) Bulging of the hypertrophied anterior cruciate ligament. Meniscectomy was undertaken in 11 cases (41%). Indian J Orthop 48(2):197202. However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. Mucoid change or mucoid degeneration refers to the irreversible tissue degeneration due to the accumulation of mucin within the fibers of tendons, ligaments, and fibrocartilage. Sep 2017 - Feb 20186 months. Generally, we know little about this condition. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. PMC Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. HHS Vulnerability Disclosure, Help MDACL is differentiated from synovial cysts of the anterior cruciate ligament (ACL) where, in MDACL, mucoid tissue intermingles within ACL fibres and is not contained within a cyst [3]. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Before . and transmitted securely. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Mucoid degeneration of ACL. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. AJR Am J Roentgenol. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. 2011;19(3):408411. Arch Orthop Trauma Surg. Please enable it to take advantage of the complete set of features! 2 ). 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.
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