in 1999 [ 1 ]. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. official website and that any information you provide is encrypted 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. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. -. 1. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). 1). 1992;159(2):35760. Keywords: Please enable it to take advantage of the complete set of features! Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Arthroscopy. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. Its signal is increased on all sequences. (10%) and highest in the study of Ventura et al. See this image and copyright information in PMC. FOIA This is a rare pathological condition, in which, there is increased signal from within the ligament. Careers. The success of treatment for MDACL and the subsequent risk of instability is not known. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. 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. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Mucoid degeneration of A C L is more common and literature has also reported many cases, but for PCL only few cases have been reported in English literature. Initially, partial weightbearing is allowed. 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). Bethesda, MD 20894, Web Policies Read More Created for people with ongoing healthcare needs but benefits everyone. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. eCollection 2021. Epub 2010 May 8. JBR-BTR. 2011. Knee Surg Sports Traumatol Arthrosc. The site is secure. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. An official website of the United States government. Bookshelf Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). In the nine included studies, four different scores were used for outcome assessment. Clin Orthop Surg. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. Glossary of terms for musculoskeletal radiology. and transmitted securely. Skelet Radiol 30(6):312315. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Indian J Orthop 46(5):561565. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. Case report: 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. This site needs JavaScript to work properly. 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. PubMed Central J Chin Med Assoc. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. Epub 2011 Feb 18. 2010 Jun 1;96(4):400-6. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. This makes it difficult to relate the improvement of symptoms to ACL debridement. J Chin Med Assoc. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Here are the search results of the thread mucoid degeneration of acl treatment from Bing. The ligament is mainly responsible for restraining anterior translation of knee. Indian J Orthop 48(2):197202. [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%). The primary intervention was arthroscopic ACL debridement in eight studies; this was combined with notchplasty in cases of impingement with the lateral wall of the notch in five studies [6, 14, 16,17,18] (Table 3). Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. 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. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Average patient age was 49 (22 to 68) years. Clipboard, Search History, and several other advanced features are temporarily unavailable. (100%). Bookshelf The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. No treatment is usually required. The anterior cruciate ligament (ACL) is an important ligament in the knee. Conclusions: This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. 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. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. mucoid degeneration acl symptoms. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. official website and that any information you provide is encrypted Knee Surg Sports Traumatol Arthrosc. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. government site. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. (A) Bulging of, Fig. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. 1. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. 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. Cite this article. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. The .gov means its official. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Before MeSH Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. (B) Partial resection, MeSH 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. MM and A performed the literature search, and data analysis. However, MDACL is asymptomatic in most patients. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. 2011. None of the studies was a randomised controlled trial and none had a control group. PMC Twelve partial and 17 total resections were performed. Eight studies reported postoperative instability. and transmitted securely. FOIA Results: Pandey, Vivek et al. Orthop Traumatol Surg Res. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Unable to process the form. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. The minimum follow-up was 3 years. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. 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. Conclusions. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Indian J Orthop. Accessibility National Library of Medicine The mean follow up ranged from 13 to 72months. Khanna 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. report that one patient had ACL reconstruction simultaneously after the ACL debridement. Symptomatic ACL mucoid degeneration in middle-age athletes. It is a chronic degenerative change of a bulky ACL that may lead to notch . Clipboard, Search History, and several other advanced features are temporarily unavailable. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Discussion: IV (retrospective cohort study). The authors declare that they have no competing interests. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. 2012;4 (2): 167-70. to 44% in the study of Cha et al. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Morice et al. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. 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. Mucoid degeneration of the anterior cruciate ligament. That is usually the journal article where the information was first stated. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. 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]. 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. Epub 2010 May 8. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. https://doi.org/10.1016/j.arthro.2003.11.030, Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Characteristic: "celery stalk" appearance. Rehabilitation, speech therapy, crenotherapy. This systematic review has some limitations. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Roberts CC, Towers JD, Spangehl MJ et-al. . It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Pan African Medical Journal. 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. Generally, we know little about this condition. Introduction: What is myxoid degeneration treatment? Epub 2013 Aug 27. 2006;69(9):44952. did not report on this. Am J Roentgenol 182(5):12831287. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. eCollection 2022 May-Jun. 6. 2004;182(5):12837. 2011 Jun;25(6):650-2. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. Mucoid degeneration of the anterior cruciate ligament. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate The appearance can mimic acute or chronic interstitial partial tears of the ACL. Knee Surgery & Related Research The .gov means its official. 2011. National Library of Medicine [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Mucoid degeneration of both ACL and PCL. reported on the co-existence of mucoid degeneration and ganglia of the ACL. Orthop Traumatol Surg Res 99(6):693697, Khanna G, Sharma R, Bhardwaj A, Gurdutta HS, Agrawal DK, Rathore AS (2016) Mucoid degeneration of the anterior cruciate ligament: partial arthroscopic debridement and outcomes. 2011 Aug 1;19(8):1326-33. 5. Bookshelf The site is secure. You can read more if you want. Orthop Traumatol Surg Res. ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6.
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