8600 Rockville Pike Unauthorized use of these marks is strictly prohibited. Arthroscopic debridement may help relieve the anterior knee pain. 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. 287 (3): 912-921. However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. What Is Mucoid Degeneration of the ACL? mucoid degeneration acl symptoms. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. J Orthop. Conclusions: Mucoid degeneration of the ACL is a clinical condition afflicting active middle-aged people without a single significant traumatic episode with a specific MRI picture. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. . Bethesda, MD 20894, Web Policies The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. The .gov means its official. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Physical therapy typically begins 7-10 days after the procedure. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. The ligament is mainly responsible for restraining anterior translation of knee. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. The clinical presentation is one of posterior pain with limited flexion. Reeducation. 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. ANZ J Surg 73(9):712716. mucoid degeneration of acl mri. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. 6. Questions just answered: mucoid degeneration of acl physiotherapy. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Disclaimer. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Bookshelf . Management of mucoid degeneration of the anterior cruciate ligament: a systematic . -. 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. 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. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Meniscectomy was undertaken in 11 cases (41%). Bookshelf [6], in 62% of patients (18 of 29) in the study of Lintz et al. 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). 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. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Rehabilitation, speech therapy, crenotherapy. Epub 2021 Mar 8. The https:// ensures that you are connecting to the (Table 3). 2011 Aug 1;19(8):1326-33. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Epub 2018 Apr 21. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Only nine studies met our inclusion criteria and they were all case series. 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). Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. 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. Its signal is increased on all sequences. sharing sensitive information, make sure youre on a federal Bookshelf Anterior cruciate ligament mucoid degeneration. Tamer Sweed. 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. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. 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. Sagittal T2-weighted MRI view showing intact anterior, Fig. Skeletal Radiol. Unable to load your collection due to an error, Unable to load your delegates due to an error. When refering to evidence in academic writing, you should always try to reference the primary (original) source. and transmitted securely. Arthroscopy. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Mucoid degeneration of ACL. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. The https:// ensures that you are connecting to the Please enable it to take advantage of the complete set of features! MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. Instrumental treatment. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. Orthop Traumatol Surg Res. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . PMC Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. 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. 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. Federal government websites often end in .gov or .mil. Mucoid degeneration of the anterior cruciate ligament: a case report. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Epub 2011 Feb 18. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. 2011 Mar;25(3):262-5. 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. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. (100%). Arch Orthop Trauma Surg. 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]. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. At the time the article was created Frank Gaillard had no recorded disclosures. Symptoms included limited range of motion (ROM) and posterior knee pain. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). 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. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. Introduction: Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. The cause is not really known, but patients usually do not complain of instability. J Bone Joint Surg Br. This site needs JavaScript to work properly. The site is secure. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. and transmitted securely. The rate of simultaneous meniscectomy ranged from 13 to 44%. 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. Any discrepancy was resolved by the senior author. The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. Cite this article. 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). Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Unauthorized use of these marks is strictly prohibited. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. National Library of Medicine 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. The mean age at the time of surgery was 57 years (range, 31 to 78 years). 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. The mean follow up ranged from 13 to 72months. Clipboard, Search History, and several other advanced features are temporarily unavailable. Would you like email updates of new search results? Download Citation | On Feb 1, 2023, O.R. 2011 Jun;25(6):650-2. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [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 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. Read More Created for people with ongoing healthcare needs but benefits everyone. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. See this image and copyright information in PMC. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-3615, Case 11: with Hoffa fat pad ganglion cyst, Case 12: tibial nerve schwannoma and ACL mucoid degeneration, Case 1: Complete ACL tear and meniscal tears, Case 2: Anomalous insertion of the medial meniscus, View Frank Gaillard's current disclosures, see full revision history and disclosures, anterior cruciate ligament ganglion cysts, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Mucoid degeneration of the anterior cruciate ligament, congenital or acquired synovial tissue entrapment between ACL fibers. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. government site. Knee Surg Sports Traumatol Arthrosc. Before eCollection 2022 May-Jun. Other theories include Degenerative theory- MD could occur due to ageing.[3]. The appearance can mimic acute or chronic interstitial partial tears of the ACL. https://doi.org/10.1302/0301-620X.81B2.0810304, Article Introduction: We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. Skeletal Radiology. what causes mucoid degeneration of acl. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Preoperative magnetic resonance imaging (MRI) scan. AJR Am J Roentgenol. Unauthorized use of these marks is strictly prohibited. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review, https://doi.org/10.1186/s43019-021-00110-6, https://doi.org/10.1302/0301-620X.81B2.0810304, https://doi.org/10.1007/s00167-011-1433-0, https://doi.org/10.2214/ajr.182.5.1821283, https://doi.org/10.1007/s00167-012-1991-9, https://doi.org/10.1016/j.arthro.2003.11.030, https://doi.org/10.1016/j.jclinepi.2009.06.005, http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782, https://doi.org/10.1046/j.1445-2197.2003.02748.x, http://journals.sagepub.com/doi/10.1177/2325967118786930, http://www.ijcrar.com/abstractview.php?ID=228&vol=4-11-2016&SNo=3, https://doi.org/10.1016/j.arthro.2008.02.004, https://doi.org/10.1016/j.jajs.2015.12.001, https://doi.org/10.4055/cios.2018.10.3.307, http://creativecommons.org/licenses/by/4.0/, http://creativecommons.org/publicdomain/zero/1.0/. 2013;15(1). On clinical examination, the active range of motion showed a flexion deficit. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. (10%) and highest in the study of Ventura et al. CAS Careers. J Knee Surg. 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. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Chudasama et al. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. 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 . Unable to process the form. 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. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. However, the authors did not report whether there were any other patients with symptomatic instability. Hypothesis: https://doi.org/10.1016/j.arthro.2008.02.004, Morice A, Coupry A, Lintz F, Robert H (2013) Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. MDACL is differentiated from synovial cysts of the anterior cruciate ligament (ACL) where, in MDACL, mucoid tissue intermingles within ACL fibres and is not contained within a cyst [3]. volume33, Articlenumber:26 (2021) Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Individuals with mucoid degeneration of the ACL were excluded. An official website of the United States government. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). Individuals were included in the study if they had had complete MRIs of the affected knee at baseline and at 4-year follow-up, had thigh MRIs at baseline and had no additional surgery in the meantime. That is usually the journal article where the information was first stated. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. 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. Arthroscopic findings. Epub 2010 May 8. -, 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. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. Methods: Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Arthroscopic findings. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Arthroscopy. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. 8600 Rockville Pike : A Meta-Analysis. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 2. Seventeen females (67%) and eight males (33%) were included in the final analysis.
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