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Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. . 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. See this image and copyright information in PMC. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. 2007;90(3):1923. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Disclaimer. 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. 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.). National Library of Medicine 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. have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. https://doi.org/10.1016/j.jclinepi.2009.06.005. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Ventura et al. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. Skeletal Radiol. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). Instrumental treatment. Symptoms included limited range of motion (ROM) and posterior knee pain. The origin of MDACL may be degenerative or traumatic. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. Knee Surg Sports Traumatol Arthrosc. On clinical examination, the active range of motion showed a flexion deficit. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). [Diagnosis and treatment of anterior cruciate ligament cysts]. Sweed, T., Mussa, M., El-Bakoury, A. et al. 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. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. 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). Arch Orthop Trauma Surg. Radiology. 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. 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. 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. Federal government websites often end in .gov or .mil. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Physical therapy typically begins 7-10 days after the procedure. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. This site needs JavaScript to work properly. Resnick D, Kransdorf MJ. Categories were determined in accordance with the study of Ekhtiari et al. 2. Each study was scored 02 on each question, with a global ideal score of 16. Preoperative and postoperative results of eleven patient were compared. It can cause pain and to a meniscal tear. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Arthroscopic debridement may help relieve the anterior knee pain. [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%). Knee Surgery & Related Research It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. Anterior Cruciate Ligament, is an important structure of the knee joint. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. J Bone Joint Surg Br. . Postoperative clinical laxity was common, however, symptomatic instability was not. It is a chronic degenerative change of a bulky ACL that may lead to notch . and Ventura et al. 1173185. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. In the Lintz study, total resection of the ACL was performed in 17 out of 29 knees, while in the Ventura study total resection was performed in 17 out of 25 patients. The site is secure. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 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. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Patients will . Risk factors Predisposing factors include the following 1: aging Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Federal government websites often end in .gov or .mil. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. All nine studies were case series; six were retrospective and three were prospective studies. Questions just answered: mucoid degeneration of acl physiotherapy. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. Anatomopathology samples were collected in 18 cases. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Method. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. (Table 3). The anterior cruciate ligament (ACL) is an important ligament in the knee. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. CAS Arthroscopic findings. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. Besides, the patient may also have trouble in moving. 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. 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]. Accessibility There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. 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. Indian J Orthop 48(2):197202. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. 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). Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Glossary of terms for musculoskeletal radiology. However, the authors did not report whether there were any other patients with symptomatic instability. It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. reported the largest percentage of patients (27.5%) with a positive pivot test. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. Epub 2010 May 8. Disclaimer. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. The appearance can mimic acute or chronic interstitial partial tears of the ACL. 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). Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. This ranged from 90 to 95% in all studies, except in the report by Kim et al., where only 53.8% of patients (57/106) had complete pain relief after surgery. 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 debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. https://doi.org/10.4055/cios.2018.10.3.307, University Hospitals of Derby and Burton, Uttoxeter Rd, Derby, DE22 3NE, UK, Trauma and Orthopaedic Speciality Trainee, West Midlands Deanery, Birmingham Rotation, Birmingham, UK, University Hospitals Plymouth NHS Trust, Plymouth, UK, University of Alexandria, Alexandria, Egypt, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry, CV2 2DX, UK, You can also search for this author in Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. National Library of Medicine what causes mucoid degeneration of acl. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Truncation means that the . International Journal of Orthopaedics. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. 2012;4 (2): 167-70. You can read more if you want. government site. Case report: Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. Postoperative symptomatic instability was not common in eight studies, but was observed in 48% of patients in the study of Lintz et al., with two patients having a delayed ACL reconstruction. Mumbai, Maharashtra, India. 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. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. 2011 Mar;25(3):262-5. Before Individuals with mucoid degeneration of the ACL were excluded. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Knee Surg & Relat Res 33, 26 (2021). Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. An official website of the United States government. 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. However, MDACL is asymptomatic in most patients. After the literature search and exclusion of duplicates, 54 papers were retrieved: 12 articles were assessed for eligibility, and of these, 9 papers met the inclusion criteria and were included in the systematic review [3, 6, 13,14,15,16,17,18,19] (Fig. There was strong association with chondral lesions and meniscal tears. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Second, methodological quality assessment showed that three studies had low methodological quality.