Case report: 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. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Epub 2008 Apr 18. 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. Springer Nature. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). Introduction: Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. This site needs JavaScript to work properly. -. Online ahead of print. 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. Bone and joint imaging. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. ACL tears don't heal as such. Mucoid degeneration of ACL is a disease affecting ACL in which mucoid like substance (glycosaminoglycans) gets interspersed within the substance of ACL and as a result ACL gets thickened. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. IV (retrospective cohort study). Physical Therapy. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. Magn Reson Imaging Clin N Am. . Mucoid degeneration of the anterior cruciate ligament. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. and transmitted securely. 1. Careers. 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. There was more than 20% loss to follow up in the study of Kim et al., while the three prospective studies had no loss to follow up [13, 14, 18]. Intact fibers are best seen on T2WI. TS designed the project, literature search and wrote the manuscript. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. HHS Vulnerability Disclosure, Help https://doi.org/10.1007/s00167-011-1433-0, Article 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. 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 . That is usually the journal article where the information was first stated. Copyright 2010 Elsevier Masson SAS. Arthroscopy. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . The appearance can mimic acute or chronic interstitial partial tears of the ACL. A 48-year-old-male patient presented with knee pain and limitation of motion. (10%) and highest in the study of Ventura et al. 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). Arch Orthop Trauma Surg. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Arthroscopy 20(2):141146. Arthroscopy. The extracted data were assessed for meta-analysis. 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 ). This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. (A) Bulging of the hypertrophied anterior cruciate ligament. Arthroscopy 24(6):642649. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. However, the authors did not report whether there were any other patients with symptomatic instability. They respond well to a judicious arthroscopic release of the ACL with notchplasty. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. 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. Please enable it to take advantage of the complete set of features! eCollection 2022 May-Jun. The purpose of this study was to investigate the outcomes of management of mucoid degeneration of the anterior cruciate ligament (MDACL) by performing a systematic review of methods of treatment that have been reported. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. This makes it difficult to relate the improvement of symptoms to ACL debridement. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 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 . 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. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Learn how we can help 704 views Reviewed >2 years ago Thank ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. 2007;15 (1): 73-86. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. 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 ]. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. (Table 3). Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. Average postoperative International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were 71.2 (42.5 to 92.0) and 78.2 (26.4 to 99). Would you like email updates of new search results? We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. https://doi.org/10.4055/cios.2018.10.3.307, University Hospitals of Derby and Burton, Uttoxeter Rd, Derby, DE22 3NE, UK, Trauma and Orthopaedic Speciality Trainee, West Midlands Deanery, Birmingham Rotation, Birmingham, UK, University Hospitals Plymouth NHS Trust, Plymouth, UK, University of Alexandria, Alexandria, Egypt, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry, CV2 2DX, UK, You can also search for this author in Online ahead of print. Open Grey database was searched for grey literature using the same keywords. 2011. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). 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. Online ahead of print. Epub 2013 Aug 27. Indian J Orthop. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. Symptoms included limited range of motion (ROM) and posterior knee pain. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. National Library of Medicine All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). did not report on this. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. Imaging: Plain radiographs Level of Evidence: Level IV. Accessibility bling. Conclusions. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. 1992;159(2):35760. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Disclaimer. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. PMC 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. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. PubMed What causes mucoid degeneration of ACL? The mean follow up ranged from 13 to 72months. Introduction: 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. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. https://doi.org/10.4103/0019-5413.128765, Article Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Knee Surg Sports Traumatol Arthrosc. Conclusion: Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, most pronounced at 6-7 and small disc herniations at 5-6 and C4-5, with slight interval progression at 5-6. . Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. The pathogenesis remains controversial. Bethesda, MD 20894, Web Policies 2013;15(1). -. 8600 Rockville Pike An official website of the United States government. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. in 1999 [1]. 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.). to 44% in the study of Cha et al. Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons. AJR Am J Roentgenol. After the literature search and exclusion of duplicates, 54 papers were retrieved: 12 articles were assessed for eligibility, and of these, 9 papers met the inclusion criteria and were included in the systematic review [3, 6, 13,14,15,16,17,18,19] (Fig. Epub 2018 Jan 2. A total of 313 knees in 292 patients were included. 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.
North Carolina Business Emergency Operations Center,
The Last Lid Shark Tank Net Worth,
Revolutionary War Sites In Western Massachusetts,
David Portnoy House Montauk,
Articles M