In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. 1. Mucoid degeneration of both ACL and PCL - PubMed Knee Surg Sports Traumatol Arthrosc. National Center for Biotechnology Information Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. Other theories include Degenerative theory- MD could occur due to ageing.[3]. 5. Bookshelf Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). [PDF] Mucoid degeneration of the anterior cruciate Ligament: a case Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. J Arthrosc Joint Surg 3(1):2833. Please enable it to take advantage of the complete set of features! Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. in 1999 [ 1 ]. NCI CPTC Antibody Characterization Program. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. It is a chronic degenerative change of a bulky ACL that may lead to notch . After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. All rights reserved. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Part of Bone and joint imaging. Download Citation | On Feb 1, 2023, O.R. Accessibility Skeletal Radiology. 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). Arthroscopy. Mucoid degeneration of ACL. Ventura et al. 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. Indian J Orthop 46(5):561565. https://doi.org/10.4103/0019-5413.128765, Article HHS Vulnerability Disclosure, Help Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). You can read more if you want. https://doi.org/10.1016/j.jclinepi.2009.06.005. 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. Epub 2010 May 8. Arthroscopy. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. Knee Surg Sports Traumatol Arthrosc. 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. The https:// ensures that you are connecting to the The mean follow up ranged from 13 to 72months. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 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. Arthroscopy 24(6):642649. Mucoid degeneration of the anterior cruciate ligament: can platelet FOIA Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. 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. These appearances must be differentiated from mucoid degeneration of the intact ACL. 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. 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. There was strong association with chondral lesions and meniscal tears. Patients and methods: Orthop Traumatol Surg Res. Keywords: We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. . (A) Bulging of, Fig. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. The cause is not really known, but patients usually do not complain of instability. 2018;4(4):875-80. However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). 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. . -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. PDF Mucoid degenerated anterior cruciate ligament managed by arthroscopic mucoid degeneration of acl - Best Orthopedic doctor in Jaipur 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. Clin Orthop Surg. CAS Mucoid degeneration of the anterior cruciate ligament ADVERTISEMENT: Supporters see fewer/no ads. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. -, 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. report that one patient had ACL reconstruction simultaneously after the ACL debridement. A total of 313 knees in 292 patients were included. The .gov means its official. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 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. The aetiology of MDACL is not clearly understood. -. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Online ahead of print. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. Mucinous material within the substance of ACL produces pain and limited motion in the knee. Its signal is increased on all sequences. 2 ). AJR Am J Roentgenol. Twelve partial and 17 total resections were performed. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. Accessed 1 Mar 2021. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. Increased posterior slope and coronal inclination of the tibial joint 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). 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? There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Score: 4.7/5 (45 votes) . Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Background: Mucoid degeneration of anterior cruciate ligament (ACL) Would you like email updates of new search results? Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Glossary of terms for musculoskeletal radiology. The authors declare that they have no competing interests. PDF Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration: A Review and Ventura et al. 1. Mucoid degeneration of the patellar ligament in athletes. ANZ J Surg 73(9):712716. MRI - Interstitial ACL tear With Mild knee joint effusion ,No evidence of discontinuation of fibre Can Interstitial ACL tear heal without surgery Asked for Male, 22 Years 78 Views v Dr. Abhishek Kaushik Joint Replacement Surgeon | Delhi 1/1 people found this helpful Hi. AJR Am J Roentgenol. Check for errors and try again. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. Seventeen females (67%) and eight males (33%) were included in the final analysis. Postoperative recovery was four weeks on average. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. On clinical examination, the active range of motion showed a flexion deficit. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Pain was posterior in 23 knees (80%). Federal government websites often end in .gov or .mil. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Clinical significance of T2*-weighted gradient-echo MRI to monitor Unable to load your collection due to an error, Unable to load your delegates due to an error. and transmitted securely. Preoperative magnetic resonance imaging (MRI) scan. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). government site. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Arthroscopy. proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. Clipboard, Search History, and several other advanced features are temporarily unavailable. 8600 Rockville Pike Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. 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. Level of Evidence: Level IV. Orthopedics; anterior cruciate ligament; arthoscopy. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Bethesda, MD 20894, Web Policies 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. PMC 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 . What is acl mucoid degeneration? | HealthTap Online Doctor -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. mucoid degeneration acl symptoms. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. J Chin Med Assoc. Anatomopathology samples were collected in 18 cases. Indian J Orthop 48(2):197202. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. W B Saunders Co. (2005) ISBN:0721602703. 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. eCollection 2021. No treatment is usually required. 2004;182(5):12831287. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. AJR Am J Roentgenol. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Unable to process the form. Anterior knee pain is the more common complaint. The https:// ensures that you are connecting to the ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Symptomatic instability was highest in the study of Lintz et al. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. Bethesda, MD 20894, Web Policies Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. It results in postoperative laxity, but rarely in frank instability. For non-comparative studies, this consists of eight questions. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. 2011. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Unlike meniscal tears and chondral defects, the mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain and there have been no case reports of mucoid degeneration of both the ACL and the posterior cruciate ligament (PCL). 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. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Cho SD, Youm YS, Lee CC et-al. Individuals with mucoid degeneration of the ACL were excluded. ACL Ganglion Cysts - Radsource statement and (A) Bulging of the hypertrophied anterior cruciate ligament. Arthroscopic diagnostic criteria [7] are (1) continuous ACL fibres, (2) increased ACL volume, (3) yellowish-coloured material expressed on palpation and (4) loss of ACL synovial lining. Unauthorized use of these marks is strictly prohibited. The mean age of patients ranged from 31 to 78years. 2008;24(6):642649. official website and that any information you provide is encrypted eCollection 2013. JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. 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. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. The clinical presentation is one of posterior pain with limited flexion. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. 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. Knee Surgery & Related Research Knee. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. sharing sensitive information, make sure youre on a federal J Knee Surg. FOIA Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). Pandey, Vivek et al. Symptomatic ACL mucoid degeneration in middle-age athletes The pathogenesis remains controversial. (PDF) Assessment of imaging, pathoanatomy and - Academia.edu The clinical presentation is one of posterior pain with limited flexion. It can cause pain and to a meniscal tear. 1992;159(2):35760. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. 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). Knee Surg & Relat Res 33, 26 (2021). Reeducation. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. The site is secure. 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. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . -. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Arthroscopy. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. 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. 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.). J Clin Epidemiol 62(10):10061012. Mucoid degeneration of the anterior cruciate ligament Chudasama et al. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Federal government websites often end in .gov or .mil. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report in 1999 [1]. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Disclaimer. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. Case report: intra-tendinous ganglion of the anterior cruciate ligament