Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. This was lowest in the study of Cha et al. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. The site is secure. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Sweed, T., Mussa, M., El-Bakoury, A. et al. JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. J Orthop. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. Mucoid change or mucoid degeneration refers to the irreversible tissue degeneration due to the accumulation of mucin within the fibers of tendons, ligaments, and fibrocartilage. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). -, Hodler J, Haghighi P, Trudell D, Resnick D. The cruciate ligaments of the knee: Correlation between MR appearance and gross and histologic findings in cadaveric specimens. Learn.Physio on LinkedIn: Quadriceps and hamstring weakness are common J Clin Epidemiol 62(10):10061012. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). Characteristic: "celery stalk" appearance. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Ayurvedic treatment for complete acl tear - Practo Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). 2007;245 (3): 916-7. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Careers. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. The rate of simultaneous meniscectomy ranged from 13 to 44%. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Arthroscopy. Am J Roentgenol 182(5):12831287. 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. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. Please enable it to take advantage of the complete set of features! 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. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Rehabilitation, speech therapy, crenotherapy. J Bone Joint Surg Br. The appearance can mimic acute or chronic interstitial partial tears of the ACL. PMC The mean follow up ranged from 13 to 72months. sharing sensitive information, make sure youre on a federal Mucoid degeneration of ACL | Mayo Clinic Connect FOIA To our knowledge, this is the first systematic review to look into the results of the management of MDACL. Disclaimer. The .gov means its official. A total of 313 knees in 292 patients were included. https://doi.org/10.2214/ajr.182.5.1821283, Article ACL debridement was partial in all studies except for those by Lintz et al. All rights reserved. Mucoid degeneration of anterior cruciate ligament (ACL) Mucoid degeneration of ACL - Osteoporosis - inspire.com Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Indian J Orthop 48(2):197202. Correspondence to Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. 2. Terms and Conditions, Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. The .gov means its official. 2007;15 (1): 73-86. 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. 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.). Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. Bone and joint imaging. Its signal is increased on all sequences. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Case report: 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. (61years), which was the largest study and represented more than one third of the total patients included in this review. Radiology. 8600 Rockville Pike Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). 6. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Conclusions. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. report that one patient had ACL reconstruction simultaneously after the ACL debridement. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Preoperative magnetic resonance imaging (MRI), Fig. Khanna et al. Federal government websites often end in .gov or .mil. 2023 BioMed Central Ltd unless otherwise stated. None of the studies was a randomised controlled trial and none had a control group. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. Conclusion: Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Bookshelf Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. -, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK. 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. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). The site is secure. Mucoid degeneration of the anterior cruciate ligament. 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. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. AJR Am J Roentgenol. There is no consensus on treatment and evidence is scarce. The extracted data were assessed for meta-analysis. Knee Surg Sports Traumatol Arthrosc. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. 2007;90(3):1923. The authors declare that they have no competing interests. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Symptomatic ACL mucoid degeneration in middle-age athletes. (10%) and highest in the study of Ventura et al. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. Would you like email updates of new search results? 5. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Score: 4.7/5 (45 votes) . Mucoid degeneration of the anterior cruciate ligament All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. Anterior cruciate ligament mucoid degeneration: selecting the best Bethesda, MD 20894, Web Policies Arthroscopic findings. 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). Arthroscopic debridement of the ACL resulted in good pain relief and improved range of movement in all studies, with postoperative improvement in the knee scores. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. Risk factors Predisposing factors include the following 1: aging Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Mumbai, Maharashtra, India. Keywords: Magnetic Resonance Imaging is the most useful tool for differentiating mucoid degeneration of the ACL from an intraligamentous ganglion or other lesions in the knee joint and if this disease is considered preoperatively, it can be diagnosed easily based on characteristic findings. [Diagnosis and treatment of anterior cruciate ligament cysts]. Knee Surgery & Related Research It may lead to knee pain. 2011 Mar;25(3):262-5. Loreto v. Kijakazi, 1:22-CV-1404-JDG | Casetext Search + Citator as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. 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. and transmitted securely. ACL Ganglion Cysts - Radsource 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. 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. 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. mucoid degeneration acl symptoms. 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. This systematic review has some limitations. (100%). MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. official website and that any information you provide is encrypted Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Unable to load your collection due to an error, Unable to load your delegates due to an error. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Skeletal Radiol. Mucoid degeneration of ACL Justamom21 Feb 17, 2023 7:27 AM Among other conditions - osteoarthritis, osteopenia, spondylolisthesis- an MRI report showed "severe mucoid degeneration of the ACL" in my left knee. Mucoid degeneration of the anterior cruciate ligament. 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. bling. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Ligaments are very tough, fibrous tissue structures. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. HHS Vulnerability Disclosure, Help Indian J Orthop. eCollection 2021. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Unauthorized use of these marks is strictly prohibited. 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). Online ahead of print. Second, methodological quality assessment showed that three studies had low methodological quality. Orthopaedics & Traumatology: Surgery & Research. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Noninfiltrating synovial cysts of the ACL were excluded. . sharing sensitive information, make sure youre on a federal Magn Reson Imaging Clin N Am. 1173185. eCollection 2013. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. 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. Disclaimer. National Center for Biotechnology Information A long duration of non-specific knee pain in a patient should be evaluated with MRI. 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. Bergin et al. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. 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. Symptoms included limited range of motion (ROM) and posterior knee pain. Results: 2018;4(4):875-80. Clinical significance of T2*-weighted gradient-echo MRI to monitor Epub 2018 Apr 21. Epub 2018 Aug 22. (PDF) Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Indian J Orthop 46(5):561565. Arthroscopy 20(2):141146. Learn how we can help 704 views Reviewed >2 years ago Thank 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). Skeletal Radiology. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Truncation means that the . Bergin et al. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. 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). [17] do not mention whether any patients underwent biopsy (Table 3). Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Anatomopathology samples were collected in 18 cases. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. Ligaments and tendons are accumulated by mucoid change might display a thickened and/or hypertrophied appearance, with an increase in signal intensity. Mucoid cystic degeneration of the cruciate ligament. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT 2,375 views Sep 15, 2019 23 Dislike Dr. Prateek Joshi- Ortho 1.02K subscribers Notice Age-restricted video (based on Community Guidelines). Patients will . Anterior cruciate ligament mucoid degeneration - Radiopaedia 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. Please enable it to take advantage of the complete set of features! Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH 2004;182(5):12837. Diffuse Intrasubstance Signal Abnormalities Ofthe Posterior Cruciate It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. Mucinous material within the substance of ACL produces pain and limited motion in the knee. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Would you like email updates of new search results? 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. The .gov means its official. Discussion: The https:// ensures that you are connecting to the (B) Partial resection, MeSH JBR-BTR. Knee. J Bone Joint Surg Ser B 81(2):304305. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Patients and methods: ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Disclaimer. and Ventura et al. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Postoperative pain relief ranged from 53.8 to 95%. Clipboard, Search History, and several other advanced features are temporarily unavailable. However, MDACL is asymptomatic in most patients. Preoperative and postoperative results of eleven patient were compared. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. All patients (100%, n=11) reported an improvement in pain. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. HHS Vulnerability Disclosure, Help Accessibility Unable to process the form. However, symptomatic instability was not common. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. J Sports Med Phys Fitness 48(4):483487, PubMed Epub 2013 Aug 27. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. Despite the low rate of complications in all studies, there was a high incidence of postoperative knee laxity, demonstrated by a positive Lachman test, in most studies. 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. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. in 1999 [ 1 ]. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. 2. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes.