Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. 2001;17(9):E37. 2011;19(3):408411. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. Accessibility 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. All nine studies were case series; six were retrospective and three were prospective studies. -, Fealy S, Kenter K, Dines JS, Warren RF. 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. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Am J Roentgenol 182(5):12831287. An official website of the United States government. 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. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. statement and Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. What Is Mucoid Degeneration of the ACL? 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. Patients and methods: This site needs JavaScript to work properly. Clipboard, Search History, and several other advanced features are temporarily unavailable. Meniscectomy was undertaken in 11 cases (41%). Unauthorized use of these marks is strictly prohibited. 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. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. However, symptomatic instability was not common. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. 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. The ligament is mainly responsible for restraining anterior translation of knee. The extracted data were assessed for meta-analysis. This systematic review has some limitations. Conclusion: Please enable it to take advantage of the complete set of features! Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Orthopedics; anterior cruciate ligament; arthoscopy. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Pandey, Vivek et al. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. 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. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Sep 2017 - Feb 20186 months. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. All patients (100%, n=11) reported a good to very good surgery satisfaction. https://www.physio-pedia.com/index.php?title=Anterior_Cruciate_Ligament_(ACL)_Mucoid_Degeneration&oldid=253974, Difficulty in climbing stairs, cross-leg sitting, squatting, Primary condition- Osteoarthritis, degenerative menisci, meniscal tear, Impingement of the soft tissue in the vicinity. Tamer Sweed. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. 1. Results: It can cause pain and to a meniscal tear. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. See this image and copyright information in PMC. Mucoid degeneration of the anterior cruciate ligament. Ventura et al. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. reported the largest percentage of patients (27.5%) with a positive pivot test. sharing sensitive information, make sure youre on a federal 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. Its function is to stabilize the knee while bending and rotating; the ACL also keeps the knee from shifting out of place or moving anteriorly (toward the front) with pivoting activities. Learn how we can help 704 views Reviewed >2 years ago Thank 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. Federal government websites often end in .gov or .mil. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. 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]. 2007;15 (1): 73-86. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Accessed 1 Mar 2021. Introduction: Unauthorized use of these marks is strictly prohibited. bling. As there was no control group in any of the studies and the natural history of MDACL is not known, the postoperative improvement may have been attributed to the placebo effect, simultaneous arthroscopic procedures or the postoperative rehabilitation, or may be due to the pain having resolved without treatment at all. mucoid degeneration acl symptoms. The mean MINORS score was 9.5 (range 412). Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Bethesda, MD 20894, Web Policies Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Knee Surg Sports Traumatol Arthrosc. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. An official website of the United States government. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. government site. Categories were determined in accordance with the study of Ekhtiari et al. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. 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. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. PubMed Central -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Therefore, indications for ACL resection must be carefully selected. An official website of the United States government. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Unauthorized use of these marks is strictly prohibited. 2007;90(3):1923. Please enable it to take advantage of the complete set of features! Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. Manage cookies/Do not sell my data we use in the preference centre. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Instrumental treatment. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. mucoid degeneration of acl mri. Online ahead of print. Questions just answered: mucoid degeneration of acl physiotherapy. 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. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. government site. 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). Privacy Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. At the time the article was last revised Dai Roberts had no recorded disclosures. in 1999 [ 1 ]. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. What you feel (symptoms) You feel heaviness in knee joint. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Pain was posterior in 23 knees (80%). PMC 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). Anterior knee pain is the more common complaint. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. and transmitted securely. https://doi.org/10.1007/s00167-011-1433-0, Article Epub 2011 Feb 18. Dietary management and various treatments Scanning and diagnostic . 1173185. It is a chronic degenerative change of a bulky ACL that may lead to notch . 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). 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. FOIA In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. PMC This study concerns complete ACL resec If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. In most cases Physiopedia articles are a secondary source and so should not be used as references. Twelve partial and 17 total resections were performed. The https:// ensures that you are connecting to the Postoperative clinical laxity was common, however, symptomatic instability was not. Bergin D, Morrison WB, Carrino JA et-al. Symptomatic instability was highest in the study of Lintz et al. California Privacy Statement, This is a rare pathological condition, in which, there is increased signal from within the ligament. It results in postoperative laxity, but rarely in frank instability. sharing sensitive information, make sure youre on a federal CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. Symptomatic ACL mucoid degeneration in middle-age athletes. What causes mucoid degeneration of ACL? Anterior cruciate ligament mucoid degeneration. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. 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). Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Before Clin Orthop Surg. Orthop Traumatol Surg Res 99(6):693697, Khanna G, Sharma R, Bhardwaj A, Gurdutta HS, Agrawal DK, Rathore AS (2016) Mucoid degeneration of the anterior cruciate ligament: partial arthroscopic debridement and outcomes. Physiotherapy. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. There was strong association with chondral lesions and meniscal tears. This site needs JavaScript to work properly. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Google Scholar, Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D (2011) Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Epub 2013 Aug 27. and Ventura et al. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. All nine studies assessed the outcome of arthroscopic debridement of MDACL. 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 Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. 1). National Library of Medicine 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.