CAS Unauthorized use of these marks is strictly prohibited. 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. 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. 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 ]. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Symptoms included limited range of motion (ROM) and posterior knee pain. Arch Orthop Trauma Surg. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. mucoid degeneration of acl - Best Orthopedic doctor in Jaipur All rights reserved. in 1999 [1]. 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. -. Radiology. Level of Evidence: Level IV. Initially, partial weightbearing is allowed. Knee Surg Sports Traumatol Arthrosc. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. What are the treatment options for anterior cruciate ligament mucoid and transmitted securely. Physical Therapy. Rehabilitation, speech therapy, crenotherapy. Arthroscopic management of mucoid degeneration of anterior cru Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. ACL MUCOID DEGENERATION RADIOLOGY MRI - Radedasia The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Conclusions. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. The total number of patients with symptomatic instability was 18 out of 288 (6%). https://doi.org/10.4103/0019-5413.128765, Article 2007;245 (3): 916-7. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Arthroscopic findings. Arthroscopy. PMC 2. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Epub 2011 Feb 18. 2. The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. This site needs JavaScript to work properly. Knee Surgery & Related Research Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. Clipboard, Search History, and several other advanced features are temporarily unavailable. Anterior cruciate ligament mucoid degeneration: MR findings An official website of the United States government. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review, https://doi.org/10.1186/s43019-021-00110-6, https://doi.org/10.1302/0301-620X.81B2.0810304, https://doi.org/10.1007/s00167-011-1433-0, https://doi.org/10.2214/ajr.182.5.1821283, https://doi.org/10.1007/s00167-012-1991-9, https://doi.org/10.1016/j.arthro.2003.11.030, https://doi.org/10.1016/j.jclinepi.2009.06.005, http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782, https://doi.org/10.1046/j.1445-2197.2003.02748.x, http://journals.sagepub.com/doi/10.1177/2325967118786930, http://www.ijcrar.com/abstractview.php?ID=228&vol=4-11-2016&SNo=3, https://doi.org/10.1016/j.arthro.2008.02.004, https://doi.org/10.1016/j.jajs.2015.12.001, https://doi.org/10.4055/cios.2018.10.3.307, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. Mucoid change | Radiology Reference Article | Radiopaedia.org 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]. Symptomatic instability was highest in the study of Lintz et al. What causes myxoid degeneration? - Shabupc.com Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. Bergin et al. in 1999 [ 1 ]. Knee Surg Sports Traumatol Arthrosc. How is mucoid degeneration treated? - Sdnimik.bluejeanblues.net The .gov means its official. Please enable it to take advantage of the complete set of features! Conclusion: Mucoid degeneration of the anterior cruciate ligament. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Epub 2018 Jan 2. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). J Orthop. Mucoid degeneration of the anterior cruciate ligament: Partial Mucoid degeneration of the anterior cruciate ligament #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. Bookshelf The ligament is mainly responsible for restraining anterior translation of knee. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. The appearance can mimic acute or chronic interstitial partial tears of the ACL. PDF Mucoid degenerated anterior cruciate ligament managed by arthroscopic Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Please enable it to take advantage of the complete set of features! Would you like email updates of new search results? Postoperative recovery was four weeks on average. Hypothesis: https://doi.org/10.1302/0301-620X.81B2.0810304, Article Arthroscopy. [PDF] Mucoid degeneration of the anterior cruciate Ligament: a case Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. ACL Ganglion Cysts - Radsource HHS Vulnerability Disclosure, Help Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. PMC The https:// ensures that you are connecting to the 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). (61years), which was the largest study and represented more than one third of the total patients included in this review. Pandey, Vivek et al. J Sports Med Phys Fitness 48(4):483487, PubMed Careers. NCI CPTC Antibody Characterization Program. Correspondence to 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. An official website of the United States government. Manage cookies/Do not sell my data we use in the preference centre. Sep 2017 - Feb 20186 months. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI official website and that any information you provide is encrypted The mean age at the time of surgery was 57 years (range, 31 to 78 years). 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. Imaging: Plain radiographs Anterior Cruciate Ligament (ACL) Mucoid Degeneration - Physiopedia Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. (PDF) Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration Diffuse Intrasubstance Signal Abnormalities Ofthe Posterior Cruciate Mucoid degeneration of the anterior cruciate ligament. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . 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. Patients will . Pain was posterior in 23 knees (80%). 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. reported on the co-existence of mucoid degeneration and ganglia of the ACL. Online ahead of print. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. [17] do not mention whether any patients underwent biopsy (Table 3). Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. 6. 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. . 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). 2012;4 (2): 167-70. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Indian J Orthop 48(2):197202. 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. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. government site. It has recently been postulated that mucoid degeneration of the ACL is related to the medial knee compartment joint space loss in patients with osteoarthritis or in the OA risk group 6. Arch Orthop Trauma Surg. Bergin D, Morrison WB, Carrino JA et-al. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. 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 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). Terms and Conditions, PubMed Bone and joint imaging. 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. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Morice et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bilateral Symptomatic Mucoid Degeneration of the Anterior - Hindawi [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%). Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. 2023 BioMed Central Ltd unless otherwise stated. In the nine included studies, four different scores were used for outcome assessment. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Keywords: Mucoid cystic degeneration of the cruciate ligament. Deep Seated Pain at Back of Knee with Bending | Dr HC Chang The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Risk factors Predisposing factors include the following 1: aging Introduction to Arthroscopic Debridement A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . 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. 2007;90(3):1923. 4. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. 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]. 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]. Its signal is increased on all sequences. 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. This study concerns complete ACL resec Clin Orthop Surg. Accessibility Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. -, Fealy S, Kenter K, Dines JS, Warren RF. Individuals with mucoid degeneration of the ACL were excluded. A total of 313 knees in 292 patients were included in the nine studies. Orthop Traumatol Surg Res. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 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. Bookshelf In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. There is no consensus on treatment and evidence is scarce. Epub 2011 Feb 18. Provided by the Springer Nature SharedIt content-sharing initiative. Mucoid degeneration of the anterior cruciate ligament - PubMed Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed.
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