Knee Surg Sports Traumatol Arthrosc. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. (48.2% (14/29 patients) with symptomatic instability), which may be due to the large number of patients with total resection of the ACL (58.6% (17 out of 29 patients)) (Table 4). Open Grey database was searched for grey literature using the same keywords. What is Anterior Cruciate Ligament Mucoid Degeneration? 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. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. 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 . Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate Introduction: 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. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Disclaimer. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. : A Meta-Analysis. Please enable it to take advantage of the complete set of features! Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Symptomatic ACL mucoid degeneration in middle-age athletes. Epub 2018 Aug 22. Preoperative magnetic resonance imaging (MRI) scan. 2001;30(6):312315. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. 1. It may lead to knee pain. Bergin et al. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. Federal government websites often end in .gov or .mil. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Bethesda, MD 20894, Web Policies Mumbai, Maharashtra, India. PROSPERO. 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. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Arthroscopy. AJR Am J Roentgenol. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Please enable it to take advantage of the complete set of features! Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. ANZ J Surg 73(9):712716. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. 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. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. 2010 Jun 1;96(4):400-6. The author(s) read and approved the final manuscript. sharing sensitive information, make sure youre on a federal Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Noninfiltrating synovial cysts of the ACL were excluded. 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). Ventura et al. 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. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Along with that, it also controls the internal rotation. Mucoid degeneration of the anterior cruciate ligament (ACL) is regarded as a degenerative change in the ligament, which is clinically presented with pain on full extension or flexion in the middle-aged population. Conclusions: Terms and Conditions, The reported restriction of range of movement was flexion deficit in four studies [3, 13, 15, 17], extension deficit in one study [14] and combined flexion and extension deficit in four studies [6, 16, 18, 19] (Table4). Accessibility government site. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. Any discrepancy was resolved by the senior author. AJR Am J Roentgenol. and Ventura et al. 1173185. The extracted data were heterogeneous in terms of outcome assessment. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). [6], in 62% of patients (18 of 29) in the study of Lintz et al. 2006;69(9):44952. and transmitted securely. 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. Bergin et al. J Chin Med Assoc. Level of Evidence: Level IV. Mucoid degeneration of the anterior cruciate ligament. Read More Created for people with ongoing healthcare needs but benefits everyone. PubMed [Diagnosis and treatment of anterior cruciate ligament cysts]. Before However, symptomatic instability was not common. Mucoid degeneration of ACL. You can read more if you want. Unable to load your collection due to an error, Unable to load your delegates due to an error. Knee Surg Sports Traumatol Arthrosc. Careers. The cause is not really known, but patients usually do not complain of instability. statement and With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. An official website of the United States government. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. 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. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). 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. MM and A performed the literature search, and data analysis. It is a chronic degenerative change of a bulky ACL that may lead to notch . 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 ). Epub 2013 Aug 27. Mucoid cystic degeneration of the cruciate ligament. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. None of the studies was a randomised controlled trial and none had a control group. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. FOIA Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. government site. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. See this image and copyright information in PMC. Conclusion: Postoperative pain relief was reported in seven studies. 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. 2011. [16]. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. 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]. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. 2011 Mar;25(3):262-5. The retrospective study by Kim et al. A long duration of non-specific knee pain in a patient should be evaluated with MRI. to 44% in the study of Cha et al. Advanced MR imaging of the cruciate ligaments. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Bookshelf If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. 1992;159(2):35760. All rights reserved. Symptomatic ACL mucoid degeneration in middle-age athletes. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). Preoperative magnetic resonance imaging (MRI), Fig. . 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 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]. FOIA Accessed 1 Mar 2021. 2007;245 (3): 916-7. Risk factors Predisposing factors include the following 1: aging Cho SD, Youm YS, Lee CC et-al. Copyright 2010 Elsevier Masson SAS. The appearance can mimic acute or chronic interstitial partial tears of the ACL. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. 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). The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. Generally, we know little about this condition. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. J Clin Epidemiol 62(10):10061012. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. This site needs JavaScript to work properly. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. Online ahead of print. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Postoperative pain relief ranged from 53.8 to 95%. Clipboard, Search History, and several other advanced features are temporarily unavailable. Careers. The anterior cruciate ligament (ACL) is an important ligament in the knee. Epub 2010 May 8. Epub 2011 Feb 18. 2004;182(5):12831287. Would you like email updates of new search results? Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007;15 (1): 73-86. Questions just answered: mucoid degeneration of acl physiotherapy. The primary intervention was arthroscopic ACL debridement in eight studies; this was combined with notchplasty in cases of impingement with the lateral wall of the notch in five studies [6, 14, 16,17,18] (Table 3). Unauthorized use of these marks is strictly prohibited. 3. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. https://doi.org/10.2214/ajr.182.5.1821283, Article -Evaluated and planned treatment protocol in accordance with physician. A total of 313 knees in 292 patients were included. 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. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Epub 2008 Apr 18. 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. A 48-year-old-male patient presented with knee pain and limitation of motion. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). Its signal is increased on all sequences. Cookies policy. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Would you like email updates of new search results? https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. The extracted data were assessed for meta-analysis. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. 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 Here are the search results of the thread mucoid degeneration of acl treatment from Bing. Mucoid degeneration of the anterior cruciate ligament. Epub 2018 Apr 21. 8600 Rockville Pike Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. By using this website, you agree to our The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. 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).