Online ahead of print. 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. and Ventura et al. Mucoid degeneration itself is described as a yellow or brown substance which can be either seen through the most anterior fibers of the ACL or found by probing between them [ 19, 35] (Fig. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. Bethesda, MD 20894, Web Policies Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. Physiotherapy. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms This site needs JavaScript to work properly. (B) Partial resection, MeSH J Orthop. Unauthorized use of these marks is strictly prohibited. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Online ahead of print. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. Careers. On clinical examination, the active range of motion showed a flexion deficit. At the time the article was last revised Dai Roberts had no recorded disclosures. 2010 Jun 1;96(4):400-6. PubMed This site needs JavaScript to work properly. Arthroscopy. 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. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. Preoperative and postoperative results of eleven patient were compared. https://doi.org/10.1302/0301-620X.81B2.0810304, Article NCI CPTC Antibody Characterization Program. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Unable to process the form. Reeducation. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . An official website of the United States government. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Accessibility 1. Morice et al. 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). I have persistent pain in the back of that knee that is exacerbated by walking and bending it. J Chin Med Assoc. 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. Bergin D, Morrison WB, Carrino JA et-al. There is no consensus on treatment and evidence is scarce. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. PubMed Skeletal Radiology. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first described in the literature in 1999.1 Since then, MD-ACL has been recognized as a pathology present on between 0.7% and 5.3% of magnetic resonance images performed for knee pain.2 MD-ACL is thought to be part of a spectrum of ACL disease that can range from ganglion cysts to MD.3 MD-ACL can either be primary (idiopathic . 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. 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. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Patients will . Later studies reported that changes consist of mucoid Results degeneration, neovascularisation, and tendon sheath hyper- Nineteen patients met the inclusion criteria and were inclu- trophy. Mucoid degeneration of the anterior cruciate ligament. 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. However, MDACL is asymptomatic in most patients. The inclusion criteria for this study were (1) studies including symptomatic patients with mucoid degeneration of the ACL, (2) studies of 10 or more patients, (3) a minimum of 6months follow up and (4) patients treated conservatively or surgically (arthroscopic debridement with or without simultaneous ACL reconstruction). That is usually the journal article where the information was first stated. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. PMC The aetiology of MDACL is not clearly understood. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. National Library of Medicine The clinical presentation is one of posterior pain with limited flexion. 1173185. Physical Therapy. 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. Symptomatic ACL mucoid degeneration in middle-age athletes. 3. to 44% in the study of Cha et al. Orthopaedics & Traumatology: Surgery & Research. 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. Epub 2008 Apr 18. sharing sensitive information, make sure youre on a federal Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. PMC 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. 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. Discussion: 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. Indian J Orthop 48(2):197202. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. 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. Arthroscopic findings. Epub 2010 May 8. The mean MINORS score was 9.5 out of 16 (412). It may lead to knee pain. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. 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. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. This systematic review has some limitations. TS designed the project, literature search and wrote the manuscript. FOIA government site. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. in 1999 [1]. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. bling. Knee Surg Sports Traumatol Arthrosc. Hide glossary Glossary. The authors declare that they have no competing interests. 2. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. what causes mucoid degeneration of acl. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. This study concerns complete ACL resec 5. Orthop Traumatol Surg Res. This was lowest in the study of Cha et al. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 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 ). 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. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. PubMedGoogle Scholar. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. Hypothesis: It is a chronic degenerative change of a bulky ACL that may lead to notch . Roberts CC, Towers JD, Spangehl MJ et-al. Arch Orthop Trauma Surg. https://doi.org/10.2214/ajr.182.5.1821283, Article HHS Vulnerability Disclosure, Help Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. 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). AJR Am J Roentgenol. JBR-BTR. 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. Mucinous material within the substance of ACL produces pain and limited motion in the knee. For non-comparative studies, this consists of eight questions. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Knee Surgery & Related Research 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. government site. eCollection 2022 May-Jun. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Before The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. The mean follow up ranged from 13 to 72months. Disclaimer. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. Unable to load your collection due to an error, Unable to load your delegates due to an error. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. This may support the theory that it is a degenerative process. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. 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. The .gov means its official. All patients (100%, n=11) reported an improvement in pain. J Bone Joint Surg Br. Epub 2013 Aug 27. Arch Orthop Trauma Surg. 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. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. 1999;81(2):304305. What is myxoid degeneration treatment? On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. FOIA 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. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . Bergin et al. 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. Before 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 . Bookshelf 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. official website and that any information you provide is encrypted 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. Cite this article. sharing sensitive information, make sure youre on a federal Chudasama et al. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. The mean follow up ranged from 13 to 72months. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). You can read more if you want. 8600 Rockville Pike At the time the article was created Frank Gaillard had no recorded disclosures. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. and transmitted securely. In the nine included studies, four different scores were used for outcome assessment. 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. Arthroscopy. All nine studies were case series; six were retrospective and three were prospective studies. Knee Surg Sports Traumatol Arthrosc 21(3):658663. 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. Epub 2010 May 8. Risk factors Predisposing factors include the following 1: aging 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. 2006;69(9):44952. There was a high rate of association between degenerative lesions and MDACL, ranging from 39 to 96%. Epub 2018 Aug 22. Provided by the Springer Nature SharedIt content-sharing initiative. Disclaimer. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Meniscectomy was undertaken in 11 cases (41%). Clipboard, Search History, and several other advanced features are temporarily unavailable. Imaging: Plain radiographs Part of The https:// ensures that you are connecting to the When refering to evidence in academic writing, you should always try to reference the primary (original) source. [Diagnosis and treatment of anterior cruciate ligament cysts]. Keywords: 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Would you like email updates of new search results? J Chin Med Assoc. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. sharing sensitive information, make sure youre on a federal The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Epub 2021 Mar 8. The origin of MDACL may be degenerative or traumatic. HHS Vulnerability Disclosure, Help 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. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. : A Meta-Analysis. 2. What causes mucoid degeneration of ACL? Score: 4.7/5 (45 votes) . The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. No treatment is usually required. https://doi.org/10.1016/j.jclinepi.2009.06.005. 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. Fourteen knees (48%) had limited flexion, on average 97 degrees. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate 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. Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. Careers. Signal intensity of the anteromedial bundle (AMB) or posterolateral bundle (PLB) graft standardized to the intensity of the PCL was defined as signal intensity ratio (SIR). Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. 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. J Knee Surg. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing.
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