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. Provided by the Springer Nature SharedIt content-sharing initiative. An official website of the United States government. Online ahead of print. 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.). bling. 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). Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. All patients (100%, n=11) reported an improvement in pain. Rehabilitation, speech therapy, crenotherapy. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). [Diagnosis and treatment of anterior cruciate ligament cysts]. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity that has been found in patients with pain and limited range of motion of the knee in association with a bulky ACL shown on magnetic resonance imaging (MRI). This was lowest in the study of Cha et al. J Sports Med Phys Fitness 48(4):483487, PubMed had the largest number of patients (91) with a mean age of 61 years, which was the oldest study population amongst the nine studies [16]. There was strong association with chondral lesions and meniscal tears. eCollection 2022 May-Jun. PMC 1). This may support the theory that it is a degenerative process. (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). in 1999 [ 1 ]. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Mucoid degeneration of both ACL and PCL. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). Bookshelf Eight studies reported postoperative instability. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. Mucoid degeneration of ACL. Therefore, indications for ACL resection must be carefully selected. Knee Surg Sports Traumatol Arthrosc. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. The mean age at the time of surgery was 57 years (range, 31 to 78 years). 8600 Rockville Pike #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. sharing sensitive information, make sure youre on a federal PubMed Central Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. 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. sharing sensitive information, make sure youre on a federal Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Roberts CC, Towers JD, Spangehl MJ et-al. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . The total number of patients with symptomatic instability was 18 out of 288 (6%). The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. AJR Am J Roentgenol. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. Four studies reported only postoperative scores, which were comparable to those in other studies. Knee. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Arthroscopy. J Clin Epidemiol 62(10):10061012. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. Epub 2018 Aug 22. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Ligaments hold our bones together and allow us to bend, twist, pivot and rapidly accelerate and decelerate and yet maintain the stability of our joints. Indian J Orthop 48(2):197202. Intact fibers are best seen on T2WI. 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. 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. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. Clipboard, Search History, and several other advanced features are temporarily unavailable. -, Fealy S, Kenter K, Dines JS, Warren RF. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. 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. Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. The extracted data were heterogeneous in terms of outcome assessment. ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. 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. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. and transmitted securely. A total of 313 knees in 292 patients were included in the nine studies. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. The .gov means its official. 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). [17] do not mention whether any patients underwent biopsy (Table 3). Epub 2018 Jun 13. J Arthrosc Joint Surg 3(1):2833. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. 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. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Sweed, T., Mussa, M., El-Bakoury, A. et al. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon non-traumatic cause of knee pain and motion restriction, typically seen in a middle-aged population. The appearance can mimic acute or chronic interstitial partial tears of the ACL. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). Coronal proton density-weighted magnetic resonance, Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate, Sagittal proton density-weighted magnetic resonance, Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased, Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate, Pre-debridement arthroscopic view showing yellowish. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. Two patients uderwent secondary ligamentoplasty. 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). . Characteristic: "celery stalk" appearance. HHS Vulnerability Disclosure, Help official website and that any information you provide is encrypted Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. 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). An 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. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. The author(s) read and approved the final manuscript. Generally, we know little about this condition. official website and that any information you provide is encrypted What is Anterior Cruciate Ligament Mucoid Degeneration? 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 long duration of non-specific knee pain in a patient should be evaluated with MRI. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. California Privacy Statement, Seventeen females (67%) and eight males (33%) were included in the final analysis. Federal government websites often end in .gov or .mil. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). None of the studies was a randomised controlled trial and none had a control group. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. 2018;4(4):875-80. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. The ligament is mainly responsible for restraining anterior translation of knee. 2011 Jun;25(6):650-2. Clinical outcome was reported using a variety of scores (the Lysholm and International Knee Documentation Committee (IKDC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the visual analogue scale (VAS) score) in the different studies; these are summarized in Table 4. IV (retrospective cohort study). Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Anterior Cruciate Ligament, is an important structure of the knee joint. The mean follow up ranged from 13 to 72months. Risk factors Predisposing factors include the following 1: aging Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Methods: The minimum follow-up was 3 years. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Before Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Rehabilitation, orthophony, crenotherapy. Conclusion: The mean age of patients ranged from 31 to 78years. 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. what causes mucoid degeneration of acl. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Khanna et al. Knee Surg Sports Traumatol Arthrosc. National Library of Medicine Arthroscopy. Unable to load your collection due to an error, Unable to load your delegates due to an error. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. 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. Open Grey database was searched for grey literature using the same keywords. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Am J Roentgenol 182(5):12831287. Mucoid degeneration of the anterior cruciate ligament. 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. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. 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. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Careers. Before Copyright 2010 Elsevier Masson SAS. 2. 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]. Disclaimer. did not report on this. [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%). 2023 BioMed Central Ltd unless otherwise stated. Knee Surg Sports Traumatol Arthrosc 21(3):658663. The clinical presentation is one of posterior pain with limited flexion. Methods: Epub 2008 Dec 17. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Manage cookies/Do not sell my data we use in the preference centre. 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. 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.
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