(Table 3). Morice et al. That is usually the journal article where the information was first stated. It results in postoperative laxity, but rarely in frank instability. Truncation means that the . Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. 2018. http://journals.sagepub.com/doi/10.1177/2325967118786930, Pandey V, Suman C, Sharma S, Rao SP, Kiran Acharya K, Sambaji C (2014) Mucoid degeneration of the anterior cruciate ligament: management and outcome. Seventeen females (67%) and eight males (33%) were included in the final analysis. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Mucoid degeneration of the anterior cruciate ligament. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. There was an improvement in postoperative range of motion and outcome scores (Lysholm and International Knee Documentation Committee scores and the Knee Injury and Osteoarthritis Outcome Score). Reeducation. AJR Am J Roentgenol. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Arthroscopy. Epub 2013 Aug 27. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Fourteen knees (48%) had limited flexion, on average 97 degrees. Diffuse Intrasubstance Signal Abnormalities Ofthe Posterior Cruciate There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Hide glossary Glossary. Privacy 2008;24(6):642649. https://doi.org/10.1046/j.1445-2197.2003.02748.x, Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a systematic review. Clinical significance of T2*-weighted gradient-echo MRI to monitor Mucoid degeneration of anterior cruciate ligament (ACL) CAS . Papadopoulou P. The celery stalk sign. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. 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. 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/. KoreaMed Synapse Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Epub 2008 Dec 17. What is Anterior Cruciate Ligament Mucoid Degeneration? official website and that any information you provide is encrypted Unauthorized use of these marks is strictly prohibited. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 2011. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Cite this article. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The https:// ensures that you are connecting to the Introduction to Arthroscopic Debridement Tamer Sweed. in 1999 [1]. Glossary of terms for musculoskeletal radiology. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Conclusions: Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Careers. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Correspondence to Dietary management and various treatments Scanning and diagnostic . The mean age at the time of surgery was 57 years (range, 31 to 78 years). Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. It results in postoperative laxity, but rarely in frank instability. 2011. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. eCollection 2022 May-Jun. 6. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Discussion: Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). 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. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. National Library of Medicine Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. mucoid degeneration of acl mri. TS designed the project, literature search and wrote the manuscript. An official website of the United States government. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. Epub 2013 Aug 27. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). 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. Chudasama CH, Chudasama VC, Prabhakar MM. Clin Orthop Surg. 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. Mucoid degeneration of the anterior cruciate ligament - PubMed Arch Orthop Trauma Surg. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. sharing sensitive information, make sure youre on a federal Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Knee Surg Sports Traumatol Arthrosc. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. 1992;159(2):35760. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. 2010 Jun 1;96(4):400-6. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Unauthorized use of these marks is strictly prohibited. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Preoperative magnetic resonance imaging (MRI) scan. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. These appearances must be differentiated from mucoid degeneration of the intact ACL. 1 Its prevalence in magnetic resonance imaging (MRI) is 1.8-5.3%, but not all lesions are symptomatic.2, 3 It is characterized by infiltration of mucoid-like substance (glycosaminoglycans) interspersed within the 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. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Disclaimer. 1. -Evaluated and planned treatment protocol in accordance with physician. By using this website, you agree to our Reeducation. This systematic review has some limitations. Two patients uderwent secondary ligamentoplasty. Unable to load your collection due to an error, Unable to load your delegates due to an error. Orthop Traumatol Surg Res 96(4):400406, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Case report: Instrumental treatment. 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. Twelve partial and 17 total resections were performed. Eight studies reported postoperative instability. (PDF) Assessment of imaging, pathoanatomy and - Academia.edu Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. -. Bergin D, Morrison WB, Carrino JA et-al. Anterior Cruciate Ligament (ACL) Mucoid Degeneration - Physiopedia Mucoid degeneration of the anterior cruciate ligament. in 1999 [ 1 ]. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine What causes mucoid degeneration of ACL? Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. Would you like email updates of new search results? 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. Indian J Orthop 46(5):561565. Pandey, Vivek et al. It is a chronic degenerative change of a bulky ACL that may lead to notch . The https:// ensures that you are connecting to the It may lead to knee pain. PubMed Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. 2. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. The extracted data were assessed for meta-analysis. On clinical examination, the active range of motion showed a flexion deficit. National Library of Medicine 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. 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. All nine studies were case series; six were retrospective and three were prospective studies. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. https://doi.org/10.1007/s00167-012-1991-9, McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. 2013;15(1). In the Lintz study, total resection of the ACL was performed in 17 out of 29 knees, while in the Ventura study total resection was performed in 17 out of 25 patients. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Orthopedics; anterior cruciate ligament; arthoscopy. Generally, we know little about this condition. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Advanced MR imaging of the cruciate ligaments. Pain was posterior in 23 knees (80%). In the nine included studies, four different scores were used for outcome assessment. : A Meta-Analysis. HHS Vulnerability Disclosure, Help 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). Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report Mucoid degeneration of the ACL is a rare cause of knee pain.1-8) This lesion of the ACL was first reported by Kumar et al.3) in 1999. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. HHS Vulnerability Disclosure, Help Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. 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. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a well-recognized pathology characterized by the degradation of collagen fibers and infiltration of a mucoidlike substance, [1,2 . sharing sensitive information, make sure youre on a federal All rights reserved. This site needs JavaScript to work properly. Mucoid degeneration of the anterior cruciate ligament: can platelet Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Mucoid degeneration of ACL - Osteoporosis - inspire.com Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Deep Seated Pain at Back of Knee with Bending | Dr HC Chang This site needs JavaScript to work properly. 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. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Accessibility Mucoid degeneration of the anterior cruciate ligament 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). Disclaimer. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI Rehabilitation, speech therapy, crenotherapy. https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. PMC It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. J Sports Med Phys Fitness 48(4):483487, PubMed 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). Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. Bilateral Symptomatic Mucoid Degeneration of the Anterior - Hindawi Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. The mean MINORS score was 9.5 out of 16 (412). 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 ]. Bookshelf The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Careers. MeSH Anterior cruciate ligament mucoid degeneration: Selecting the best No treatment is usually required. Disclaimer. Mucoid degeneration of ACL | Mayo Clinic Connect Anterior cruciate ligament mucoid degeneration: MR findings Bethesda, MD 20894, Web Policies 4. Bookshelf In six of the nine studies [6, 14, 16,17,18], arthroscopic debridement of the ACL was associated with simultaneous partial meniscectomy; this ranged from 13% in the study of Morice et al. The https:// ensures that you are connecting to the Knee Surg & Relat Res 33, 26 (2021). Anatomopathology samples were collected in 18 cases. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Skeletal Radiol. 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. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. The quality of methodology was excellent in one study, good in five studies, low in two studies and very low in one study (Tables 1 and 2). Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. Epub 2018 Jan 2. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. A total of 313 knees in 292 patients were included. Accessed 1 Mar 2021. 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. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. 2 ). ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. J Arthrosc Joint Surg 3(1):2833. Anterior cruciate ligament mucoid degeneration - Radiopaedia Mucinous material within the substance of ACL produces pain and limited motion in the knee. This was lowest in the study of Cha et al. Partial Anterior Cruciate Ligament - ACL - Tears - Howard J. Luks, MD Please enable it to take advantage of the complete set of features! The mean follow up ranged from 13 to 72months. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. J Clin Epidemiol 62(10):10061012. J Chin Med Assoc. Accessibility This site needs JavaScript to work properly. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. Level of Evidence: Level IV. [Diagnosis and treatment of anterior cruciate ligament cysts]. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). The appearance can mimic acute or chronic interstitial partial tears of the ACL. 2023 BioMed Central Ltd unless otherwise stated. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Federal government websites often end in .gov or .mil. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. The aetiology of MDACL is not clearly understood. https://www.physio-pedia.com/index.php?title=Anterior_Cruciate_Ligament_(ACL)_Mucoid_Degeneration&oldid=253974, Difficulty in climbing stairs, cross-leg sitting, squatting, Primary condition- Osteoarthritis, degenerative menisci, meniscal tear, Impingement of the soft tissue in the vicinity. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. 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 . They respond well to a judicious arthroscopic release of the ACL with notchplasty. Second, methodological quality assessment showed that three studies had low methodological quality. Level of evidence: 2011. Four studies reported only postoperative scores, which were comparable to those in other studies. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT - YouTube Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Online ahead of print. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. California Privacy Statement, 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. eCollection 2022 May-Jun. FOIA what causes mucoid degeneration of acl. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Magn Reson Imaging Clin N Am.
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