Springer Nature. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Categories were determined in accordance with the study of Ekhtiari et al. 2011 Aug 1;19(8):1326-33. 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HHS Vulnerability Disclosure, Help Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Mucoid degeneration of the anterior cruciate ligament. Disclaimer. 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. https://doi.org/10.4103/0019-5413.128765, Article Patients and methods: 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. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. It is a chronic degenerative change of a bulky ACL that may lead to notch . Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Mucoid change | Radiology Reference Article | Radiopaedia.org Cureus | Anterior Cruciate Ligament Ganglion Cyst and Mucoid Mucoid degeneration of the anterior cruciate ligament -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. JBR-BTR. Bone and joint imaging. Learn.Physio on LinkedIn: Quadriceps and hamstring weakness are common It can cause pain and to a meniscal tear. Epub 2008 Apr 18. Roberts CC, Towers JD, Spangehl MJ et-al. 8600 Rockville Pike government site. . PMC Epub 2011 Feb 18. eCollection 2013. Physiotherapy. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. There was strong association with chondral lesions and meniscal tears. Would you like email updates of new search results? 1. 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). Anterior Cruciate Ligament (ACL) MRI: Practice Essentials, Anatomy Fig. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. Any discrepancy was resolved by the senior author. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. Epub 2021 Nov 24. and transmitted securely. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. What causes myxoid degeneration? - Shabupc.com Cite this article. 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. J Knee Surg. All nine studies were case series; six were retrospective and three were prospective studies. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. AJR Am J Roentgenol. Symptomatic instability was highest in the study of Lintz et al. 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. Arthroscopy. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Unauthorized use of these marks is strictly prohibited. Individuals were included in the study if they had had complete MRIs of the affected knee at baseline and at 4-year follow-up, had thigh MRIs at baseline and had no additional surgery in the meantime. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. AJR Am J Roentgenol. Preoperative magnetic resonance imaging (MRI), Fig. -. 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 National Library of Medicine A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Reeducation. Bethesda, MD 20894, Web Policies 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. Mucoid degeneration of anterior cruciate ligament (ACL) In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). By using this website, you agree to our J Sports Med Phys Fitness 48(4):483487, PubMed Knee Surg Sports Traumatol Arthrosc. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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. -Evaluated and planned treatment protocol in accordance with physician. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. 2011;19(3):408411. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine An official website of the United States government. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Patients will . Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Ayurvedic treatment for complete acl tear - Practo Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. 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. official website and that any information you provide is encrypted Anterior Cruciate Ligament, is an important structure of the knee joint. 2018;4(4):875-80. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. The aetiology of MDACL is not clearly understood. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. The https:// ensures that you are connecting to the 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. 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. 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. (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). PubMed 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. 1. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Mucoid degeneration of the anterior cruciate ligament In the nine included studies, four different scores were used for outcome assessment. Introduction: Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a Case report: Clin Orthop Surg. (PDF) Assessment of imaging, pathoanatomy and - Academia.edu Tamer Sweed. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Average patient age was 49 (22 to 68) years. Knee Surg Sports Traumatol Arthrosc. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. Only nine studies met our inclusion criteria and they were all case series. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. Accessibility Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Mucoid degeneration of the anterior cruciate ligament. Skelet Radiol 30(6):312315. Epub 2018 Jan 2. For non-comparative studies, this consists of eight questions. HHS Vulnerability Disclosure, Help The anterior cruciate ligament (ACL) is an important ligament in the knee. This may support the theory that it is a degenerative process. Each study was scored 02 on each question, with a global ideal score of 16. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. The patient presented with extension block of the knee. 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. https://doi.org/10.4103/0019-5413.101037, Srivastava A, Pateliya S, Singh H, Aggarwal S, Srivastava S (2016) Mucoid degeneration of anterior cruciate ligament management and functional outcome of 18 cases. (A) Bulging of, Fig. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. -, 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. Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Arthroscopy. [Diagnosis and treatment of anterior cruciate ligament cysts]. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. Arthroscopy 24(6):642649. 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. -. Joshita Poojary - Sports Physical Therapist - Padmanabhan's - Linkedin 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. 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. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Knee Surg Sports Traumatol Arthrosc 21(3):658663. Physical therapy typically begins 7-10 days after the procedure. Two patients uderwent secondary ligamentoplasty. AJR Am J Roentgenol. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. 2011. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Bethesda, MD 20894, Web Policies Accessibility Hide glossary Glossary. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. 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. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. PROSPERO. Part of The retrospective study by Kim et al. Khanna et al. 2007;245 (3): 916-7. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. Magn Reson Imaging Clin N Am. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. See this image and copyright information in PMC. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. 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. Bookshelf The mean MINORS score was 9.5 (range 412). eCollection 2021. (61years), which was the largest study and represented more than one third of the total patients included in this review. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate Initially, partial weightbearing is allowed. 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. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. what causes mucoid degeneration of acl. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . PDF Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration: A Review The rate of simultaneous meniscectomy ranged from 13 to 44%. Epub 2018 Jun 13. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Please enable it to take advantage of the complete set of features! Conclusions: Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Management of mucoid degeneration of the anterior cruciate ligament: a CIOS :: Clinics in Orthopedic Surgery When refering to evidence in academic writing, you should always try to reference the primary (original) source. 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. Morice et al. Noninfiltrating synovial cysts of the ACL were excluded. Knee. You can read more if you want. Orthopedics; anterior cruciate ligament; arthoscopy. Symptomatic ACL mucoid degeneration in middle-age athletes. J Clin Epidemiol 62(10):10061012. 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. Meniscectomy was undertaken in 11 cases (41%). . Besides, the patient may also have trouble in moving. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. 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]. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. 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]. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. in 1999 [1]. Mumbai, Maharashtra, India. (2018) Radiology. The purpose of this study was to investigate the outcomes of management of mucoid degeneration of the anterior cruciate ligament (MDACL) by performing a systematic review of methods of treatment that have been reported. Anatomopathology samples were collected in 18 cases. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. Clipboard, Search History, and several other advanced features are temporarily unavailable. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. Intact fibers are best seen on T2WI. 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. No reconstruction was performed at the same time. Copyright 2010 Elsevier Masson SAS. Results: The success of treatment for MDACL and the subsequent risk of instability is not known. 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.). Method. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. Please enable it to take advantage of the complete set of features! Arthroscopy. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Before 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.
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