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Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. ACL tears don't heal as such. AJR Am J Roentgenol. Epub 2013 Aug 27. However, symptomatic instability was not common. This site needs JavaScript to work properly. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Categories were determined in accordance with the study of Ekhtiari et al. 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. PMC Mucoid degeneration of the anterior cruciate ligament An official website of the United States government. 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. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). 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. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. CAS Arthroscopic management of mucoid degeneration of anterior cru Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. https://doi.org/10.2214/ajr.182.5.1821283, Article and transmitted securely. in 1999 [1]. 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. Any discrepancy was resolved by the senior author. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Orthopaedics & Traumatology: Surgery & Research. Accessibility Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Disclaimer. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. Arthroscopy 20(2):141146. No reconstruction was performed at the same time. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. Chudasama CH, Chudasama VC, Prabhakar MM. (100%). Bergin et al. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. GG and AM interpreted the results and reviewed the manuscript. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Federal government websites often end in .gov or .mil. Results: Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Individuals with mucoid degeneration of the ACL were excluded. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Mucoid degeneration of the anterior cruciate ligament. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . Mucoid degeneration of the anterior cruciate ligament. This is a rare pathological condition, in which, there is increased signal from within the ligament. Level of evidence: 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. HHS Vulnerability Disclosure, Help Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. 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. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. government site. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. 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. Postoperative recovery was four weeks on average. All nine studies were case series; six were retrospective and three were prospective studies. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. The https:// ensures that you are connecting to the Skeletal Radiology. Cureus | Anterior Cruciate Ligament Ganglion Cyst and Mucoid KoreaMed Synapse Introduction: 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. Fig. Epub 2018 Jan 2. 2001;17(9):E37. In the nine included studies, four different scores were used for outcome assessment. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Initially, partial weightbearing is allowed. Symptomatic instability was highest in the study of Lintz et al. Keywords: Imaging: Plain radiographs The total number of patients with symptomatic instability was 18 out of 288 (6%). There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Arthroscopy. Mumbai, Maharashtra, India. 2004;182(5):12837. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . The anterior cruciate ligament (ACL) is an important ligament in the knee. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Epub 2021 Nov 24. Bookshelf Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. It is a chronic degenerative change of a bulky ACL that may lead to notch . Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Results: Disclaimer. A systematic literature search in the databases MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus was performed through July 2020 by three independent reviewers. What is acl mucoid degeneration? | HealthTap Online Doctor This appearance can mimic acute or chronic interstitial partial tears of the ligament. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. What does mucoid degeneration of posterior horn of medial - HealthTap as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. The extracted data were assessed for meta-analysis. Anterior cruciate ligament mucoid degeneration: Selecting the best Terms and Conditions, proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. Anterior Cruciate Ligament (ACL) MRI: Practice Essentials, Anatomy Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity that has been found in patients with pain and limited range of motion of the knee in association with a bulky ACL shown on magnetic resonance imaging (MRI). Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 2006;69(9):44952. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. Dietary management and various treatments Scanning and diagnostic . bling. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. The mean MINORS score was 9.5 (range 412). 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Questions just answered: mucoid degeneration of acl physiotherapy. What causes myxoid degeneration? - Shabupc.com Unable to process the form. Clin Orthop Surg 10(3):307314. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. PubMed It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. What are the treatment options for anterior cruciate ligament mucoid Rehabilitation, speech therapy, crenotherapy. https://doi.org/10.1302/0301-620X.81B2.0810304, Article 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. in 1999 [ 1 ]. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. 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.). Methods: The minimum follow-up was 3 years. Epub 2011 Feb 18. Disclaimer. 2007;90(3):1923. and transmitted securely. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Accessed 1 Mar 2021. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Keywords: 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. See this image and copyright information in PMC. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Federal government websites often end in .gov or .mil. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Second, methodological quality assessment showed that three studies had low methodological quality. Unlike meniscal tears and chondral defects, the mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain and there have been no case reports of mucoid degeneration of both the ACL and the posterior cruciate ligament (PCL). The cause is not really known, but patients usually do not complain of instability. Arthroscopic findings. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. and transmitted securely. JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Degeneration in ACL Injured Knees with and without - PLOS 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Before (61years), which was the largest study and represented more than one third of the total patients included in this review. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Arthroscopy. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. 8600 Rockville Pike Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. There is no consensus on treatment and evidence is scarce. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. Am J Roentgenol 182(5):12831287. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. 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. Tamer Sweed. -. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. Anatomopathology samples were collected in 18 cases. ACL Insufficiency | Anterior Knee Instability | Knee Instability Online ahead of print. 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. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Conclusion: Methods: Preoperative magnetic resonance imaging (MRI) scan. -, 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. J Arthrosc Joint Surg 3(1):2833. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients.Materials and MethodsBetween December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis . 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. Seventeen females (67%) and eight males (33%) were included in the final analysis. 287 (3): 912-921. Unauthorized use of these marks is strictly prohibited. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. 2023 BioMed Central Ltd unless otherwise stated. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. statement and On clinical examination, the active range of motion showed a flexion deficit. No treatment is usually required. Postoperative pain relief ranged from 53.8 to 95%. Arthroscopy. The patient presented with extension block of the knee. Anterior cruciate ligament mucoid degeneration: a review of the Background: Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. 2 ). There was strong association between degenerative changes and MDACL (82% having chondral and 69% meniscal lesions), which might suggest that MDACL is a degenerative process. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Ayurvedic treatment for complete acl tear - Practo FOIA Mucoid degeneration of both ACL and PCL - PubMed Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Later studies reported that changes consist of mucoid Results degeneration, neovascularisation, and tendon sheath hyper- Nineteen patients met the inclusion criteria and were inclu- trophy. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. Arthroscopic debridement may help relieve the anterior knee pain. The ligament is mainly responsible for restraining anterior translation of knee. Its signal is increased on all sequences. In most cases Physiopedia articles are a secondary source and so should not be used as references. 2011;19(3):408411. What is myxoid degeneration treatment? Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Epub 2010 May 8. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Sweed, T., Mussa, M., El-Bakoury, A. et al. 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. J Chin Med Assoc. 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. Read More Created for people with ongoing healthcare needs but benefits everyone. Arthroscopy. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Mucoid Degeneration of Posterior Cruciate Ligament with Secondary 1). Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. . International Journal of Orthopaedics. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first described in the literature in 1999.1 Since then, MD-ACL has been recognized as a pathology present on between 0.7% and 5.3% of magnetic resonance images performed for knee pain.2 MD-ACL is thought to be part of a spectrum of ACL disease that can range from ganglion cysts to MD.3 MD-ACL can either be primary (idiopathic . Arch Orthop Trauma Surg. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. and transmitted securely. The .gov means its official. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. 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. Instrumental treatment. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865.