Bookshelf The quality of methodology was excellent in one study, good in five studies, low in two studies and very low in one study (Tables 1 and 2). 4. Anterior cruciate ligament mucoid degeneration: Selecting the best 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. 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. Besides, the patient may also have trouble in moving. 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). It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Bookshelf 2011. Mucoid degeneration of the anterior cruciate ligament. I get PT and acupuncture, have had several epidural injections, and am trying hard to avoid osteoporosis meds (was on bisphosphonates for many years many years ago) as well as spinal fusion. J Chin Med Assoc. Am J Roentgenol 182(5):12831287. Questions just answered: mucoid degeneration of acl physiotherapy. Epub 2018 Jan 2. Epub 2011 Feb 18. Initially, partial weightbearing is allowed. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. in 1999 [ 1 ]. 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. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. 2008;24(6):642649. A total of nine studies were eligible for review. 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. A 48-year-old-male patient presented with knee pain and limitation of motion. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Bergin D, Morrison WB, Carrino JA et-al. Anterior cruciate ligament mucoid degeneration: MR findings Mucoid degeneration of the anterior cruciate ligament: can platelet Pain was posterior in 23 knees (80%). Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Federal government websites often end in .gov or .mil. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. The retrospective study by Kim et al. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. The knee is a complex synovial joint that can be affected by a range of pathologies: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. A total of 313 knees in 292 patients were included. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH official website and that any information you provide is encrypted A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI 5. The https:// ensures that you are connecting to the Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. PubMed In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. Ventura et al. This site needs JavaScript to work properly. AJR Am J Roentgenol. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. AJR Am J Roentgenol. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. 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. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Dietary management and various treatments Scanning and diagnostic . However, MDACL is asymptomatic in most patients. 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. Epub 2013 Aug 27. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. 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). 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. government site. Pandey, Vivek et al. National Library of Medicine It may lead to knee pain. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Disclaimer. Loreto v. Kijakazi, 1:22-CV-1404-JDG | Casetext Search + Citator This was lowest in the study of Cha 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 PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). No treatment is usually required. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. There was strong association with chondral lesions and meniscal tears. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. 2007;245 (3): 916-7. What causes myxoid degeneration? - Shabupc.com The origin of MDACL may be degenerative or traumatic. J Bone Joint Surg Ser B 81(2):304305. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). Cho SD, Youm YS, Lee CC et-al. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. PubMed Central Two patients uderwent secondary ligamentoplasty. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. Methods: Keywords: [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%). Postoperative recovery was four weeks on average. Knee Surg Sports Traumatol Arthrosc. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Careers. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. Chudasama et al. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. 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. MeSH ACL Insufficiency | Anterior Knee Instability | Knee Instability Mucoid Degeneration of the Anterior Cruciate Ligament - ResearchGate https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Resnick D, Kransdorf MJ. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. It results in postoperative laxity, but rarely in frank instability. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. It is a chronic degenerative change of a bulky ACL that may lead to notch impingement syndrome in the absence of instability symptoms and significant trauma history [ 1, 2, 3, 4 ]. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . A systematic literature search in the databases MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus was performed through July 2020 by three independent reviewers. 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. 1173185. Orthopedics; anterior cruciate ligament; arthoscopy. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. 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. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. Its signal is increased on all sequences. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Advanced MR imaging of the cruciate ligaments. Symptomatic ACL mucoid degeneration in middle-age athletes. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. All patients (100%, n=11) reported an improvement in pain. 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. 3. 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 (ACL) is a rare cause of knee pain. 1999;81(2):304305. Online ahead of print. Risk factors Predisposing factors include the following 1: aging On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. It can cause pain and to a meniscal tear. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. National Center for Biotechnology Information 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.). Accessibility Unauthorized use of these marks is strictly prohibited. Federal government websites often end in .gov or .mil. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. 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. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Sagittal T2-weighted MRI view showing intact anterior, Fig. Mucoid Degeneration Of Acl Treatment? The 140 Top Answers Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Bilateral Symptomatic Mucoid Degeneration of the Anterior - Hindawi Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report When refering to evidence in academic writing, you should always try to reference the primary (original) source. ADVERTISEMENT: Supporters see fewer/no ads. Arthroscopic management of mucoid degeneration of anterior cru Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. in 1999 [ 1 ]. Symptomatic instability was highest in the study of Lintz et al. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Bethesda, MD 20894, Web Policies MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. What does mucoid degeneration of posterior horn of medial - HealthTap The mean age at the time of surgery was 57 years (range, 31 to 78 years). https://doi.org/10.1302/0301-620X.81B2.0810304, Article The success of treatment for MDACL and the subsequent risk of instability is not known. (B) Partial resection, MeSH Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. This bicentric, retrospective cohort study with an average follow-up of 6years involved 27 patients (29 knees) presenting with symptomatic ACL mucoid degeneration validated by magnetic resonance imaging (MRI). eCollection 2022 May-Jun. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. 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. Mucoid degeneration of A C L is more common and literature has also reported many cases, but for PCL only few cases have been reported in English literature. What is myxoid degeneration treatment? What Is Mucoid Degeneration of the ACL? Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. 8600 Rockville Pike Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Epub 2021 Mar 8. 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 The .gov means its official. Careers. Skelet Radiol 30(6):312315. Introduction: 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. and Ventura et al. California Privacy Statement, and transmitted securely. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2007;90(3):1923. 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. Twelve partial and 17 total resections were performed. 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. Anterior Cruciate Ligament, is an important structure of the knee joint. Increased posterior slope and coronal inclination of the tibial joint Open Grey database was searched for grey literature using the same keywords. 2. 2011. eCollection 2022 May-Jun. Skeletal Radiol. sharing sensitive information, make sure youre on a federal How is mucoid degeneration treated? - Sdnimik.bluejeanblues.net Online ahead of print. Does mucoid degeneration of ACL require surgery? - TimesMojo Epub 2008 Apr 18. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. 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. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided.

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