Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Seventeen females (67%) and eight males (33%) were included in the final analysis. 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. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). The site is secure. Knee Surgery, Sports Traumatology, Arthroscopy. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. 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. 287 (3): 912-921. Cite this article. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. Only nine studies met our inclusion criteria and they were all case series. All nine studies were case series; six were retrospective and three were prospective studies. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Instrumental treatment. what causes mucoid degeneration of acl. 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. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. Disclaimer. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. PMC All patients (100%, n=11) reported an improvement in pain. Terms and Conditions, [6], in 62% of patients (18 of 29) in the study of Lintz et al. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. 2011 Aug 1;19(8):1326-33. Bone and joint imaging. Skelet Radiol 30(6):312315. CAS Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. The .gov means its official. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Arthroscopic diagnostic criteria [7] are (1) continuous ACL fibres, (2) increased ACL volume, (3) yellowish-coloured material expressed on palpation and (4) loss of ACL synovial lining. mucoid degeneration acl symptoms. This site needs JavaScript to work properly. official website and that any information you provide is encrypted J Orthop. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. 2007;245 (3): 916-7. (B) Partial resection, MeSH Bergin D, Morrison WB, Carrino JA et-al. -. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . MM and A performed the literature search, and data analysis. 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 Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. 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. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Bookshelf Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. Knee Surg Sports Traumatol Arthrosc. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. 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. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). official website and that any information you provide is encrypted Resnick D, Kransdorf MJ. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . Ventura et al. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. [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%). 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). 2001;17(9):E37. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Besides, the patient may also have trouble in moving. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. PMC The success of treatment for MDACL and the subsequent risk of instability is not known. These appearances must be differentiated from mucoid degeneration of the intact ACL. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. https://doi.org/10.1016/j.jajs.2015.12.001, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J (2018) Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament. Orthopedics; anterior cruciate ligament; arthoscopy. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. 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). 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 cruciate ligament, improving patient satisfaction and function without causing clinical instability in daily activities. . (A) Bulging of the hypertrophied anterior cruciate ligament. Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased signal intensity and a celery stalk appearance of intact fibers. 2023 BioMed Central Ltd unless otherwise stated. -Evaluated and planned treatment protocol in accordance with physician. The author(s) read and approved the final manuscript. An official website of the United States government. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. Score: 4.7/5 (45 votes) . 2011. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. The need for simultaneous or delayed ACL reconstruction should be discussed with patients in case total resection of the ACL is to be performed, particularly in young active patients. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Please enable it to take advantage of the complete set of features! There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. 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. (48.2% (14/29 patients) with symptomatic instability), which may be due to the large number of patients with total resection of the ACL (58.6% (17 out of 29 patients)) (Table 4). The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. PubMed 2009. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. Results: Hide glossary Glossary. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. An official website of the United States government. https://doi.org/10.1007/s00167-011-1433-0, Article This site needs JavaScript to work properly. Symptomatic instability was highest in the study of Lintz et al. 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 ]. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? and transmitted securely. Chudasama CH, Chudasama VC, Prabhakar MM. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms Mucoid degeneration of both ACL and PCL. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. 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. 2001;30(6):312315. 2011. sharing sensitive information, make sure youre on a federal 2007;15 (1): 73-86. Second, methodological quality assessment showed that three studies had low methodological quality. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Correspondence to Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. 8600 Rockville Pike 8600 Rockville Pike Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. This makes it difficult to relate the improvement of symptoms to ACL debridement. That is usually the journal article where the information was first stated. JBR-BTR. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Imaging: Plain radiographs It results in postoperative laxity, but rarely in frank instability. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Bethesda, MD 20894, Web Policies Individuals with mucoid degeneration of the ACL were excluded. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. Epub 2021 Nov 24. The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment. Clin Orthop Surg 10(3):307314. 2011 Jun;25(6):650-2. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. PubMed Hotchen AJ, Demetriou C, Edwards D, Melton JTK. Epub 2018 Jun 13. The appearance can mimic acute or chronic interstitial partial tears of the ACL. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. 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). Symptomatic ACL mucoid degeneration in middle-age athletes. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. A total of 313 knees in 292 patients were included in the nine studies. 2006;69(9):44952. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Symptomatic ACL mucoid degeneration in middle-age athletes. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. Method. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). 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). Glossary of terms for musculoskeletal radiology. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. to 44% in the study of Cha et al. HHS Vulnerability Disclosure, Help Later studies reported that changes consist of mucoid Results degeneration, neovascularisation, and tendon sheath hyper- Nineteen patients met the inclusion criteria and were inclu- trophy. Reeducation. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. (A) Bulging of, Fig. 4. The minimum follow-up was 3 years. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. IV (retrospective cohort study). 2 ). What is myxoid degeneration treatment? Therefore, indications for ACL resection must be carefully selected. 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). Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. International Journal of Orthopaedics. J Sports Med Phys Fitness 48(4):483487, PubMed Unable to load your collection due to an error, Unable to load your delegates due to an error. Bethesda, MD 20894, Web Policies 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Unauthorized use of these marks is strictly prohibited. MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. Sep 2017 - Feb 20186 months. The clinical presentation is one of posterior pain with limited flexion. The authors declare that they have no competing interests. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Khanna et al. Its signal is increased on all sequences. Epub 2018 Aug 22. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Postoperative pain relief ranged from 53.8 to 95%. Bergin et al. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. HHS Vulnerability Disclosure, Help HHS Vulnerability Disclosure, Help Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. J Orthop. Arch Orthop Trauma Surg. Mumbai, Maharashtra, India. 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. FOIA Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. However, the authors did not report whether there were any other patients with symptomatic instability. Introduction: In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines.
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