Clinical significance of T2*-weighted gradient-echo MRI to monitor To our knowledge, this is the first systematic review to look into the results of the management of MDACL. 2011. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. What Is Mucoid Degeneration of the ACL? 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. There was strong association between degenerative changes and MDACL (82% having chondral and 69% meniscal lesions), which might suggest that MDACL is a degenerative process. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. Unable to load your collection due to an error, Unable to load your delegates due to an error. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Knee Surg Sports Traumatol Arthrosc. 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. MM and A performed the literature search, and data analysis. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. Orthopaedics & Traumatology: Surgery & Research. Arthroscopic findings. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. Tamer Sweed. Methods: mucoid degeneration of acl mri. (A) Bulging of the hypertrophied anterior cruciate ligament. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. 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 The mean follow up ranged from 13 to 72months. 2009. PDF Mucoid degenerated anterior cruciate ligament managed by arthroscopic Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. It has recently been postulated that mucoid degeneration of the ACL is related to the medial knee compartment joint space loss in patients with osteoarthritis or in the OA risk group 6. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report Clinical Outcomes, Return to Sports, and Patient Satisfaction After Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients in an Asian Population-A 2-Year Follow-up Study. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. J Chin Med Assoc. https://doi.org/10.1046/j.1445-2197.2003.02748.x, Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a systematic review. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. Bethesda, MD 20894, Web Policies ACL debridement was partial in all studies except for those by Lintz et al. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. See this image and copyright information in PMC. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. None of the studies was a randomised controlled trial and none had a control group. Please enable it to take advantage of the complete set of features! We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Hypothesis: eCollection 2021. (10%) and highest in the study of Ventura et al. (PDF) Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration At the time the article was last revised Dai Roberts had no recorded disclosures. The anterior cruciate ligament (ACL) is an important ligament in the knee. J Knee Surg. 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. Bilateral Symptomatic Mucoid Degeneration of the Anterior - Hindawi Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. An official website of the United States government. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. The site is secure. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Questions just answered: mucoid degeneration of acl physiotherapy. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. and transmitted securely. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. Would you like email updates of new search results? J Bone Joint Surg Br. . https://doi.org/10.1007/s00167-011-1433-0, Article Instrumental treatment. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. reported the largest percentage of patients (27.5%) with a positive pivot test. Epub 2011 Feb 18. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. FOIA Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. government site. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Postoperative recovery was four weeks on average. 2 ). in 1999 [1]. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. By using this website, you agree to our 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]. 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. However, MDACL is asymptomatic in most patients. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. Learn.Physio on LinkedIn: Quadriceps and hamstring weakness are common Multiple theories have been put forth that explains the pathological disorganization in the collagen fibers of the Anterior Cruciate Ligament, such as synovial, traumatic, and degenerative, "Synovial theory- states that there is accumulation of synovial fluid inside the substance of ACL in a herniated pouch of synovium. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Level of Evidence: Level IV. 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. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). How is mucoid degeneration treated? - Sdnimik.bluejeanblues.net eCollection 2022 May-Jun. Mucoid degeneration of the anterior cruciate ligament. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. Terms and Conditions, Clipboard, Search History, and several other advanced features are temporarily unavailable. Bookshelf Mucoid degeneration of the anterior cruciate ligament: a case report. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Mucoid degeneration of anterior cruciate ligament (ACL) official website and that any information you provide is encrypted Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Knee Surg & Relat Res 33, 26 (2021). Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. 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. 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]. https://doi.org/10.2214/ajr.182.5.1821283, Article This site needs JavaScript to work properly. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Please enable it to take advantage of the complete set of features! 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. PROSPERO. A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment 2023 BioMed Central Ltd unless otherwise stated. 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. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Cite this article. The retrospective study by Kim et al. What is Anterior Cruciate Ligament Mucoid Degeneration? Unauthorized use of these marks is strictly prohibited. For non-comparative studies, this consists of eight questions. . Sweed, T., Mussa, M., El-Bakoury, A. et al. 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. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Keywords: Roberts CC, Towers JD, Spangehl MJ et-al. 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.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. Method. Bergin D, Morrison WB, Carrino JA et-al. The site is secure. Knee Surg Sports Traumatol Arthrosc 21(3):658663. No reconstruction was performed at the same time. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. Clipboard, Search History, and several other advanced features are temporarily unavailable. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Online ahead of print. sharing sensitive information, make sure youre on a federal what causes mucoid degeneration of acl. It results in postoperative laxity, but rarely in frank instability. 1. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. to 44% in the study of Cha et al. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. Orthop Traumatol Surg Res. 2011. The origin of MDACL may be degenerative or traumatic. Knee Surg Sports Traumatol Arthrosc. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Mucoid Degeneration of Posterior Cruciate Ligament with Secondary Disclaimer. Mucoid degeneration of the anterior cruciate ligament 1). government site. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. Meniscectomy was undertaken in 11 cases (41%). This is basically an MRI diagnosis of expansion and increased signal of an intact ACL in a person with knee pain which is worse on knee flexion/bending. Mucoid degeneration of the anterior cruciate ligament. 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. 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. Arthroscopy. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. You can read more if you want. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Reeducation. Epub 2010 May 8. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Case report: Epub 2018 Apr 21. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. ACL MUCOID DEGENERATION RADIOLOGY MRI - Radedasia Chudasama CH, Chudasama VC, Prabhakar MM. Careers. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. Mucoid degeneration of the anterior cruciate ligament: Partial Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. (Table 3). MAUDE Adverse Event Report: GENZYME BIOSURGERY (RIDGEFIELD) SYNVISC ONE 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). 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. Radiology. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. Symptomatic instability was highest in the study of Lintz et al. PubMed Before Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. eCollection 2022 May-Jun. Bethesda, MD 20894, Web Policies Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. 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. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. in 1999 [1]. The ligament is mainly responsible for restraining anterior translation of knee. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. 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. Cho SD, Youm YS, Lee CC et-al. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Knee Surgery & Related Research Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. The https:// ensures that you are connecting to the Open Grey database was searched for grey literature using the same keywords. The clinical presentation is one of posterior pain with limited flexion. Part of The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. Bergin et al. in 1999 [ 1 ]. Would you like email updates of new search results? Results: ACL Ganglion Cysts - Radsource Mucoid Degeneration of the Anterior Cruciate Ligament - ResearchGate 3. PMC There is no consensus on treatment and evidence is scarce. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. Fourteen knees (48%) had limited flexion, on average 97 degrees. Introduction to Arthroscopic Debridement ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up.
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