Mucinous material within the substance of ACL produces pain and limited motion in the knee. (2018) Radiology. 2023 BioMed Central Ltd unless otherwise stated. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. 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. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. These appearances must be differentiated from mucoid degeneration of the intact ACL. Therefore, indications for ACL resection must be carefully selected. [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%). An official website of the United States government. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. 2010 Jun 1;96(4):400-6. Arch Orthop Trauma Surg. On clinical examination, the active range of motion showed a flexion deficit. What causes mucoid degeneration of ACL? The authors declare that they have no competing interests. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. 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. Mucoid degeneration of both ACL and PCL - PubMed Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Mucoid Degeneration of the Anterior Cruciate Ligament - ResearchGate Mucoid degeneration of the anterior cruciate ligament: Partial Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. The retrospective study by Kim et al. The .gov means its official. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. Level of evidence: Before On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Epub 2018 Jan 2. Case report: intra-tendinous ganglion of the anterior cruciate ligament Generally, we know little about this condition. Preoperative magnetic resonance imaging (MRI) scan. 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. 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 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. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Physiotherapy. Accessed 1 Mar 2021. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . Disclaimer. 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. National Center for Biotechnology Information PDF Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration: A Review 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). Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. 2011. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. It is a chronic degenerative change of a bulky ACL that may lead to notch . ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra and transmitted securely. Any discrepancy was resolved by the senior author. Knee Surgery, Sports Traumatology, Arthroscopy. mucoid degeneration of acl - Best Orthopedic doctor in Jaipur Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Mucoid degeneration of the anterior cruciate ligament. Individuals with mucoid degeneration of the ACL were excluded. FOIA 2011 Aug 1;19(8):1326-33. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. Cite this article. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. 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 -Evaluated and planned treatment protocol in accordance with physician. (PDF) Assessment of imaging, pathoanatomy and - Academia.edu It results in postoperative laxity, but rarely in frank instability. An official website of the United States government. Degeneration in ACL Injured Knees with and without - PLOS report that one patient had ACL reconstruction simultaneously after the ACL debridement. -, 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. Morice et al. In the nine included studies, four different scores were used for outcome assessment. Outcome of Arthroscopic Treatment of Mucoid Degeneration 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). Methods: The minimum follow-up was 3 years. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Mucoid degeneration of the anterior cruciate ligament: can platelet sharing sensitive information, make sure youre on a federal Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report Physical therapy typically begins 7-10 days after the procedure. A total of 313 knees in 292 patients were included. government site. At the time the article was last revised Dai Roberts had no recorded disclosures. Arthroscopic treatment of mucoid degeneration of the anterior cruciate Knee Surg & Relat Res 33, 26 (2021). It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. This systematic review has some limitations. The appearance can mimic acute or chronic interstitial partial tears of the ACL. 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). 5. ADVERTISEMENT: Supporters see fewer/no ads. [Diagnosis and treatment of anterior cruciate ligament cysts]. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. Knee Surg Sports Traumatol Arthrosc. Arthroscopy. Score: 4.7/5 (45 votes) . JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI Careers. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. Arthroscopic findings. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. AJR Am J Roentgenol. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. 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. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. The cause is not really known, but patients usually do not complain of instability. Morice et al. Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment 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. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. This makes it difficult to relate the improvement of symptoms to ACL debridement. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate Unauthorized use of these marks is strictly prohibited. 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. 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). Increased posterior slope and coronal inclination of the tibial joint Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Chudasama CH, Chudasama VC, Prabhakar MM. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). J Bone Joint Surg Br. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. Conclusion: Treatment of ACL mucoid degeneration by this modality is effective in preventing recurrence, post-operative laxity and provides better functional outcome compared to the classical partial resection of the degenerated ACL. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. This appearance can mimic acute or chronic interstitial partial tears of the ligament. A 48-year-old-male patient presented with knee pain and limitation of motion. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. (100%). The .gov means its official. Anterior cruciate ligament mucoid degeneration: Selecting the best Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). No treatment is usually required. Bookshelf The origin of MDACL may be degenerative or traumatic. Mucoid degeneration of the anterior cruciate ligament. Khanna et al. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. ACL debridement was partial in all studies except for those by Lintz et al. . -, Fealy S, Kenter K, Dines JS, Warren RF. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. 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. Careers. 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. Signal intensity of the anteromedial bundle (AMB) or posterolateral bundle (PLB) graft standardized to the intensity of the PCL was defined as signal intensity ratio (SIR). The appearance can mimic acute or chronic interstitial partial tears of the ACL. Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. Level of Evidence: Level IV. [6], in 62% of patients (18 of 29) in the study of Lintz et al. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. 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. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. sharing sensitive information, make sure youre on a federal CAS Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. J Clin Epidemiol 62(10):10061012. Bilateral Symptomatic Mucoid Degeneration of the Anterior - Hindawi 2001;17(9):E37. Rehabilitation, speech therapy, crenotherapy. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. The mean MINORS score was 9.5 (range 412). volume33, Articlenumber:26 (2021) Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. 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. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. How to Treat ACL Mucoid Degeneration? - HTQ Along with that, it also controls the internal rotation. The https:// ensures that you are connecting to the 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 Orthop Traumatol Surg Res. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Mucoid degeneration of anterior cruciate ligament (ACL) maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid had the largest number of patients (91) with a mean age of 61 years, which was the oldest study population amongst the nine studies [16]. mucoid degeneration of acl mri. 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. eCollection 2013. 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.
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