Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Truncation means that the . mucoid degeneration of acl mri. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. This may support the theory that it is a degenerative process. 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. Epub 2018 Aug 22. Arthroscopic debridement may help relieve the anterior knee pain. Results: 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. 2004;182(5):12837. Epub 2010 May 8. MM and A performed the literature search, and data analysis. Radiology. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). It is a chronic degenerative change of a bulky ACL that may lead to notch . Meniscectomy was undertaken in 11 cases (41%). 2011;19(3):408411. Twelve partial and 17 total resections were performed. government site. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. Privacy The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. -Evaluated and planned treatment protocol in accordance with physician. Pain was posterior in 23 knees (80%). Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. Sweed, T., Mussa, M., El-Bakoury, A. et al. Knee Surgery & Related Research 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. The https:// ensures that you are connecting to the Physiotherapy. and Ventura et al. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Check for errors and try again. Tamer Sweed. 1. Clipboard, Search History, and several other advanced features are temporarily unavailable. Careers. Unauthorized use of these marks is strictly prohibited. However, the authors did not report whether there were any other patients with symptomatic instability. Careers. J Clin Epidemiol 62(10):10061012. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 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. NCI CPTC Antibody Characterization Program. 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. Resnick D, Kransdorf MJ. eCollection 2021. 5. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. J Chin Med Assoc. Reeducation. PROSPERO. On clinical examination, the active range of motion showed a flexion deficit. Knee Surg Sports Traumatol Arthrosc. Mucoid degeneration of the anterior cruciate ligament. The .gov means its official. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. The mean MINORS score was 9.5 (range 412). 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). -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. 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. 1173185. [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%). Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. official website and that any information you provide is encrypted I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Postoperative pain relief ranged from 53.8 to 95%. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Arthroscopy. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. An official website of the United States government. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. https://doi.org/10.1016/j.jclinepi.2009.06.005. This systematic review has some limitations. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. The patient presented with extension block of the knee. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). eCollection 2022 May-Jun. Epub 2018 Jan 2. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. The presence of intraligamentous mucoid degeneration in the ACL is demonstrated as a source of knee pain without instability and partial ACL debridement did not preclude adequate knee stability. Preoperative magnetic resonance imaging (MRI) scan. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. and transmitted securely. Arthroscopy. Bergin et al. Clin Orthop Surg. Mucoid cystic degeneration of the cruciate ligament. Federal government websites often end in .gov or .mil. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). TS designed the project, literature search and wrote the manuscript. Unauthorized use of these marks is strictly prohibited. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. What causes mucoid degeneration of ACL? What Is Mucoid Degeneration of the ACL? Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. MeSH Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. PubMed Conclusion: Characteristic: "celery stalk" appearance. 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 . Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased signal intensity and a celery stalk appearance of intact fibers. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 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 Unauthorized use of these marks is strictly prohibited. AJR Am J Roentgenol. 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. and transmitted securely. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. That is usually the journal article where the information was first stated. 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. https://doi.org/10.1302/0301-620X.81B2.0810304, Article Before Patients and methods: The site is secure. Skeletal Radiology. The extracted data were heterogeneous in terms of outcome assessment. 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. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. The site is secure. eCollection 2022 May-Jun. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. Instrumental treatment. 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. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Bethesda, MD 20894, Web Policies Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. These appearances must be differentiated from mucoid degeneration of the intact ACL. J Arthrosc Joint Surg 3(1):2833. However, MDACL is asymptomatic in most patients. . 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. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Besides, the patient may also have trouble in moving. 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.). If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Bookshelf Anterior cruciate ligament mucoid degeneration. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. PMC Introduction: The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The minimum follow-up was 3 years. Unable to load your collection due to an error, Unable to load your delegates due to an error. Anterior Cruciate Ligament, is an important structure of the knee joint. Its signal is increased on all sequences. PubMedGoogle Scholar. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. FOIA 8600 Rockville Pike Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. The https:// ensures that you are connecting to the sharing sensitive information, make sure youre on a federal 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. 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). -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. 8600 Rockville Pike Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Imaging: Plain radiographs Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. 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). Two patients uderwent secondary ligamentoplasty. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Epub 2008 Dec 17. ACL tears don't heal as such. 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]. Fig. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. 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). JBR-BTR. Arch Orthop Trauma Surg. 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. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. eCollection 2013. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Conclusions: It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. [17] do not mention whether any patients underwent biopsy (Table 3). Read More Created for people with ongoing healthcare needs but benefits everyone. J Knee Surg. Epub 2008 Apr 18. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. 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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. An official website of the United States government. MDACL is differentiated from synovial cysts of the anterior cruciate ligament (ACL) where, in MDACL, mucoid tissue intermingles within ACL fibres and is not contained within a cyst [3]. However, symptomatic instability was not common. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Would you like email updates of new search results? in 1999 [ 1 ]. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. (B) Partial resection, MeSH 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. W B Saunders Co. (2005) ISBN:0721602703. . 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 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. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Provided by the Springer Nature SharedIt content-sharing initiative. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. The clinical presentation is one of posterior pain with limited flexion. [16]. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Epub 2021 Mar 8. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Pan African Medical Journal. None of the studies was a randomised controlled trial and none had a control group. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. 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. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Fourteen knees (48%) had limited flexion, on average 97 degrees. 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. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. in 1999 [ 1 ]. AJR Am J Roentgenol. Kwee RM, Hafezi-Nejad N, Roemer FW, Zikria BA, Hunter DJ, Guermazi A, Demehri S. Association of Mucoid Degeneration of the Anterior Cruciate Ligament at MR Imaging with Medial Tibiofemoral Osteoarthritis Progression at Radiography: Data from the Osteoarthritis Initiative. The https:// ensures that you are connecting to the Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. 2011 Mar;25(3):262-5. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. You can read more if you want. Part of Federal government websites often end in .gov or .mil. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Mumbai, Maharashtra, India. The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. 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. bling. 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. Careers. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. 2010 Jun 1;96(4):400-6. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). 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. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. 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. 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. 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. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Before Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. Bethesda, MD 20894, Web Policies 2011 Jun;25(6):650-2. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Only nine studies met our inclusion criteria and they were all case series.
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