PubMed Central Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. Arthroscopic diagnostic criteria [7] are (1) continuous ACL fibres, (2) increased ACL volume, (3) yellowish-coloured material expressed on palpation and (4) loss of ACL synovial lining. 2012;4 (2): 167-70. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Management of mucoid degeneration of the anterior cruciate ligament: a Arthroscopy. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Provided by the Springer Nature SharedIt content-sharing initiative. A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Introduction: The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. The extracted data were assessed for meta-analysis. 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. 2008;24(6):642649. 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. 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. California Privacy Statement, 6. report that one patient had ACL reconstruction simultaneously after the ACL debridement. Before 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 . (100%). Meniscectomy was undertaken in 11 cases (41%). Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Ayurvedic treatment for complete acl tear - Practo PMC : A Meta-Analysis. All rights reserved. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Any discrepancy was resolved by the senior author. The success of treatment for MDACL and the subsequent risk of instability is not known. Bookshelf 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. Mucoid degeneration of the patellar ligament in athletes. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. Arthroscopic findings. Noninfiltrating synovial cysts of the ACL were excluded. Mumbai, Maharashtra, India. Arthroscopy 20(2):141146. 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. MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. 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. HHS Vulnerability Disclosure, Help Google Scholar, Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D (2011) Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. 1). However, MDACL is asymptomatic in most patients. Epub 2013 Aug 27. Therefore, indications for ACL resection must be carefully selected. 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. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Four studies reported only postoperative scores, which were comparable to those in other studies. did not report on this. Sweed, T., Mussa, M., El-Bakoury, A. et al. Symptoms included limited range of motion (ROM) and posterior knee pain. ACL tears don't heal as such. Springer Nature. Mucoid degeneration of ACL. A 48-year-old-male patient presented with knee pain and limitation of motion. Conclusions 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 . Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Epub 2010 May 8. The https:// ensures that you are connecting to the (A) Bulging of the hypertrophied anterior cruciate ligament. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. AJR Am J Roentgenol. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Advanced MR imaging of the cruciate ligaments. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. government site. Initially, partial weightbearing is allowed. Arthroscopic debridement may help relieve the anterior knee pain. Clinical significance of T2*-weighted gradient-echo MRI to monitor 2001;30(6):312315. Intact fibers are best seen on T2WI. J Clin Epidemiol 62(10):10061012. CAS 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. The pathogenesis remains controversial. https://doi.org/10.1016/j.jclinepi.2009.06.005. On clinical examination, the active range of motion showed a flexion deficit. Postoperative clinical laxity was common, however, symptomatic instability was not. J Orthop. Epub 2008 Dec 17. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. I get PT and acupuncture, have had several epidural injections, and am trying hard to avoid osteoporosis meds (was on bisphosphonates for many years many years ago) as well as spinal fusion. 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. (B) Partial resection, MeSH 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. These appearances must be differentiated from mucoid degeneration of the intact ACL. Unauthorized use of these marks is strictly prohibited. Radiofrequency Ablation for Mucoid Degeneration of the Anterior 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. Epub 2013 Aug 27. Knee Surg Sports Traumatol Arthrosc. 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. 2013;15(1). 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. The purpose of this study was to investigate the outcome of management of MDACL by performing a systematic review of methods of treatment that have been reported. Fourteen knees (48%) had limited flexion, on average 97 degrees. 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]. Reeducation. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. Bookshelf The rate of association between meniscal tears and MDACL ranged from 9 to 96%. Anterior Cruciate Ligament, is an important structure of the knee joint. The site is secure. Mucoid degeneration of both ACL and PCL. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Tamer Sweed. Furthermore, this raises the question as to whether the symptoms (pain and diminished range of movement) were solely due to MDACL and not secondary to other associated pathological conditions. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. in 1999 [ 1 ]. Average patient age was 49 (22 to 68) years. 2. 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. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. This bicentric, retrospective cohort study with an average follow-up of 6years involved 27 patients (29 knees) presenting with symptomatic ACL mucoid degeneration validated by magnetic resonance imaging (MRI). Therefore, indications for ACL resection must be carefully selected. https://doi.org/10.1016/j.jajs.2015.12.001, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J (2018) Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament. Mucoid change | Radiology Reference Article | Radiopaedia.org PubMedGoogle Scholar. 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. This site needs JavaScript to work properly. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. 2011 Aug 1;19(8):1326-33. Anterior cruciate ligament mucoid degeneration: Selecting the best Mucoid degeneration of both ACL and PCL - PubMed -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). Accessibility Before 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. reported on the co-existence of mucoid degeneration and ganglia of the ACL. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. The .gov means its official. J Knee Surg. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. There is no consensus on treatment and evidence is scarce. Other theories include Degenerative theory- MD could occur due to ageing.[3]. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. This site needs JavaScript to work properly. Generally, we know little about this condition. Each study was scored 02 on each question, with a global ideal score of 16. 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. Its signal is increased on all sequences. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). [PDF] Mucoid degeneration of the anterior cruciate Ligament: a case The patient presented with extension block of the knee. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. Cookies policy. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. Arthroscopic findings. ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra Knee Surgery, Sports Traumatology, Arthroscopy. Mucoid Degeneration Of Acl Treatment? The 140 Top Answers We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. (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). 2011;19(3):408411. IV (retrospective cohort study). Case report: Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. Knee Surg Sports Traumatol Arthrosc 21(3):658663. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Rehabilitation, speech therapy, crenotherapy. ANZ J Surg 73(9):712716. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Only nine studies met our inclusion criteria and they were all case series. Knee Surg Sports Traumatol Arthrosc. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. 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. Anterior cruciate ligament mucoid degeneration: MR findings Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. 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. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. The site is secure. PubMed The retrospective study by Kim et al. Preoperative magnetic resonance imaging (MRI), Fig. 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). Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1).