Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Symptomatic ACL mucoid degeneration in middle-age athletes. Disclaimer. All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Hypothesis: 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Postoperative clinical laxity was common, however, symptomatic instability was not. Unable to load your collection due to an error, Unable to load your delegates due to an error. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Pan African Medical Journal. [17] do not mention whether any patients underwent biopsy (Table 3). [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. 2004;182(5):12837. Each study was scored 02 on each question, with a global ideal score of 16. No reconstruction was performed at the same time. Results: Orthopaedics & Traumatology: Surgery & Research. 2011. Reeducation. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Rehabilitation, speech therapy, crenotherapy. [6], in 62% of patients (18 of 29) in the study of Lintz et al. Conclusions: Bergin D, Morrison WB, Carrino JA et-al. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). The appearance can mimic acute or chronic interstitial partial tears of the ACL. An official website of the United States government. The mean age of patients ranged from 31 to 78years. Keywords: Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Orthop Traumatol Surg Res. FOIA Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. On clinical examination, the active range of motion showed a flexion deficit. 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. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. report that one patient had ACL reconstruction simultaneously after the ACL debridement. It may lead to knee pain. HHS Vulnerability Disclosure, Help 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. Pandey, Vivek et al. 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. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-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. Arthroscopic debridement may help relieve the anterior knee pain. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Mucoid degeneration of the anterior cruciate ligament. AJR Am J Roentgenol. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Arthroscopy 24(6):642649. Accessibility Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Physical Therapy. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . Characteristic: "celery stalk" appearance. Knee Surg Sports Traumatol Arthrosc. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. what causes mucoid degeneration of acl. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Would you like email updates of new search results? Papadopoulou P. The celery stalk sign. . The aetiology of MDACL is not clearly understood. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Correspondence to At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. mucoid degeneration of acl mri. Methods: The minimum follow-up was 3 years. https://doi.org/10.4103/0019-5413.128765, Article Careers. This makes it difficult to relate the improvement of symptoms to ACL debridement. 1173185. Unable to load your collection due to an error, Unable to load your delegates due to an error. MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. 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 anterior cruciate ligament (ACL ). Arthroscopy. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. W B Saunders Co. (2005) ISBN:0721602703. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. 2010 Jun 1;96(4):400-6. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). -. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). A total of 313 knees in 292 patients were included. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. The success of treatment for MDACL and the subsequent risk of instability is not known. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. 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. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. government site. AJR Am J Roentgenol. The clinical presentation is one of posterior pain with limited flexion. Read More Created for people with ongoing healthcare needs but benefits everyone. Khanna et al. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Instrumental treatment. 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). Knee Surg Sports Traumatol Arthrosc. [16]. 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. Clin Orthop Surg. Seventeen females (67%) and eight males (33%) were included in the final analysis. Methods From January 2012 to August 2013, 32 knees (24 females and 8 males with left knee of 14 and 18 of right) were diagnosed with mucoid degeneration of the ACL and underwent arthroscopic treatment, all of whom with a mean age of 58.817.97 years (42-74 years). https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. 2011. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. California Privacy Statement, 1. PMC Methods: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Therefore, indications for ACL resection must be carefully selected. Sweed, T., Mussa, M., El-Bakoury, A. et al. 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. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid 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). 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. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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). Would you like email updates of new search results? The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. Would you like email updates of new search results? Orthopedics; anterior cruciate ligament; arthoscopy. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. 5. 2. https://doi.org/10.1302/0301-620X.81B2.0810304, Article Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Arthroscopic findings. What is Anterior Cruciate Ligament Mucoid Degeneration? National Library of Medicine 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. Two patients uderwent secondary ligamentoplasty. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42018087782). The https:// ensures that you are connecting to the Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. However, the authors did not report whether there were any other patients with symptomatic instability. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Noninfiltrating synovial cysts of the ACL were excluded. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. Mucoid degeneration of the anterior cruciate ligament: a case report. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). official website and that any information you provide is encrypted At the time the article was last revised Dai Roberts had no recorded disclosures. 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. There is no consensus on treatment and evidence is scarce. For non-comparative studies, this consists of eight questions. Score: 4.7/5 (45 votes) . Mucoid degeneration of both ACL and PCL. The pathogenesis remains controversial. The mean age at the time of surgery was 57 years (range, 31 to 78 years). "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. (100%). Bookshelf (A) Bulging of the hypertrophied anterior cruciate ligament. Mucinous material within the substance of ACL produces pain and limited motion in the knee. 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 . You can read more if you want. Background: Eight studies reported postoperative instability. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). 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. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. An official website of the United States government. 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. These appearances must be differentiated from mucoid degeneration of the intact ACL. 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 site is secure.
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