2011 Aug 1;19(8):1326-33. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Arthroscopic findings. It results in postoperative laxity, but rarely in frank instability. 2011. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). The .gov means its official. in 1999 [1]. government site. An official website of the United States government. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Unauthorized use of these marks is strictly prohibited. Springer Nature. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Generally, we know little about this condition. 2007;245 (3): 916-7. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Careers. Patient having mucoid degeneration of ACL seeks multiple orthopedic consultation and most of the time treating orthopedican miss its diagnosis either because of lack of experience or rare cause of pain unless doctor sought magnetic resonance imaging (MRI) of knee. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Rehabilitation, orthophony, crenotherapy. Symptomatic ACL mucoid degeneration in middle-age athletes. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Bergin et al. This appearance can mimic acute or chronic interstitial partial tears of the ligament. 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). 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Correspondence to Knee Surg & Relat Res 33, 26 (2021). Chudasama CH, Chudasama VC, Prabhakar MM. Bookshelf Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. 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. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Orthop Traumatol Surg Res. Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. 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. Bethesda, MD 20894, Web Policies 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. (2018) Radiology. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. 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. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. The https:// ensures that you are connecting to the 287 (3): 912-921. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. That is usually the journal article where the information was first stated. 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. 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. volume33, Articlenumber:26 (2021) Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Unable to load your collection due to an error, Unable to load your delegates due to an error. Arthroscopy. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. Individuals with mucoid degeneration of the ACL were excluded. 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. This site needs JavaScript to work properly. Fig. Patients will . 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. Check for errors and try again. Before Unable to load your collection due to an error, Unable to load your delegates due to an error. . J Sports Med Phys Fitness 48(4):483487, PubMed Its signal is increased on all sequences. 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. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. PubMed Before Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Bookshelf A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. J Clin Epidemiol 62(10):10061012. government site. Introduction: Bethesda, MD 20894, Web Policies Fourteen knees (48%) had limited flexion, on average 97 degrees. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). There was strong association with chondral lesions and meniscal tears. An official website of the United States government. This study concerns complete ACL resec Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Epub 2013 Aug 27. For non-comparative studies, this consists of eight questions. Accessed 1 Mar 2021. The origin of MDACL may be degenerative or traumatic. However, symptomatic instability was not common. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. and Ventura et al. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. In most cases Physiopedia articles are a secondary source and so should not be used as references. Only nine studies met our inclusion criteria and they were all case series. 6. The extracted data were assessed for meta-analysis. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Therefore, indications for ACL resection must be carefully selected. HHS Vulnerability Disclosure, Help 2001;17(9):E37. Therefore, indications for ACL resection must be carefully selected. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. The .gov means its official. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Seventeen females (67%) and eight males (33%) were included in the final analysis. Anterior cruciate ligament (ACL) mucoid degeneration, along with tears and anterior cruciate ligament ganglion cysts, is a relatively common cause of increased signal within the anterior cruciate ligament (ACL). See this image and copyright information in PMC. Part of Knee Surg Sports Traumatol Arthrosc 21(3):658663. 2. Postoperative recovery was four weeks on average. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Learn how we can help 704 views Reviewed >2 years ago Thank It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. Federal government websites often end in .gov or .mil. The appearance can mimic acute or chronic interstitial partial tears of the ACL. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. official website and that any information you provide is encrypted The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. 2011. Reeducation. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Besides, the patient may also have trouble in moving. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. https://doi.org/10.4103/0019-5413.128765, Article 2012;4 (2): 167-70. Knee Surg Sports Traumatol Arthrosc. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. 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. Arthroscopic findings. in this condition your acl (anterior cruciate ligament) filled with jelly like material and it thickened so space in intercondylar resion of knee joint is reduced. Careers. The site is secure. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Would you like email updates of new search results? It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. 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. https://doi.org/10.2214/ajr.182.5.1821283, Article Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Federal government websites often end in .gov or .mil. -, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. 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. The clinical presentation is one of posterior pain with limited flexion. ACL debridement was partial in all studies except for those by Lintz et al. No reconstruction was performed at the same time. The mean follow up ranged from 13 to 72months. 1992;159(2):35760. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Epub 2018 Jun 13. It is a chronic degenerative change of a bulky ACL that may lead to notch . I have persistent pain in the back of that knee that is exacerbated by walking and bending it. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. It can cause pain and to a meniscal tear. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. 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. [6], in 62% of patients (18 of 29) in the study of Lintz et al. Unable to load your collection due to an error, Unable to load your delegates due to an error. -. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. 2018;4(4):875-80. Knee Surg Sports Traumatol Arthrosc. [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%). 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Questions just answered: mucoid degeneration of acl physiotherapy. All nine studies were case series; six were retrospective and three were prospective studies. Ventura et al. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. 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. Intact fibers are best seen on T2WI. Score: 4.7/5 (45 votes) . Bethesda, MD 20894, Web Policies #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. PROSPERO. Mumbai, Maharashtra, India. reported on the co-existence of mucoid degeneration and ganglia of the ACL. 2 ). The site is secure. 2013;15(1). The appearance can mimic acute or chronic interstitial partial tears of the ACL. California Privacy Statement, 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. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. -, 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. This was lowest in the study of Cha et al. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. Epub 2011 Feb 18. The aetiology of MDACL is not clearly understood. 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]. 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. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? PubMed Central Case report: What Is Mucoid Degeneration of the ACL? The minimum follow-up was 3 years. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. The primary intervention was arthroscopic ACL debridement in eight studies; this was combined with notchplasty in cases of impingement with the lateral wall of the notch in five studies [6, 14, 16,17,18] (Table 3). 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine The site is secure. sharing sensitive information, make sure youre on a federal Mucinous material within the substance of ACL produces pain and limited motion in the knee. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons.
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