Conclusions: The .gov means its official. Bergin D, Morrison WB, Carrino JA et-al. Indian J Orthop 48(2):197202. All nine studies were case series; six were retrospective and three were prospective studies. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. 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. Disclaimer. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a well-recognized pathology characterized by the degradation of collagen fibers and infiltration of a mucoidlike substance, [1,2 . Indian J Orthop. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. For non-comparative studies, this consists of eight questions. 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). Before Average patient age was 49 (22 to 68) years. Keywords: 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 ]. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Twelve partial and 17 total resections were performed. 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. Chudasama CH, Chudasama VC, Prabhakar MM. PubMedGoogle Scholar. 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. J Knee Surg. Bergin et al. Would you like email updates of new search results? Copyright 2010 Elsevier Masson SAS. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Orthopedics; anterior cruciate ligament; arthoscopy. 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. An official website of the United States government. Individuals with mucoid degeneration of the ACL were excluded. There is no consensus on treatment and evidence is scarce. -. Physical Therapy. Any discrepancy was resolved by the senior author. FOIA Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Arch Orthop Trauma Surg. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. HHS Vulnerability Disclosure, Help https://doi.org/10.1016/j.jclinepi.2009.06.005. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Pandey, Vivek et al. 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. Chudasama et al. Results: Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. 2010 Jun 1;96(4):400-6. Preoperative magnetic resonance imaging (MRI) scan. Unauthorized use of these marks is strictly prohibited. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. 2012;4 (2): 167-70. A total of 313 knees in 292 patients were included in the nine studies. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. 8600 Rockville Pike https://doi.org/10.4103/0019-5413.101037, Srivastava A, Pateliya S, Singh H, Aggarwal S, Srivastava S (2016) Mucoid degeneration of anterior cruciate ligament management and functional outcome of 18 cases. When refering to evidence in academic writing, you should always try to reference the primary (original) source. The site is secure. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Glossary of terms for musculoskeletal radiology. Learn how we can help 704 views Reviewed >2 years ago Thank Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Unable to load your collection due to an error, Unable to load your delegates due to an error. The extracted data were heterogeneous in terms of outcome assessment. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. The mean follow up ranged from 13 to 72months. Orthop Traumatol Surg Res. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. Patients will . 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. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Before Second, methodological quality assessment showed that three studies had low methodological quality. in 1999 [ 1 ]. . Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Rehabilitation, orthophony, crenotherapy. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. 2023 BioMed Central Ltd unless otherwise stated. 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. However, the authors did not report whether there were any other patients with symptomatic instability. 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. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Knee Surg Sports Traumatol Arthrosc. Knee. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, most pronounced at 6-7 and small disc herniations at 5-6 and C4-5, with slight interval progression at 5-6. . Accessibility The patient presented with extension block of the knee. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. reported the largest percentage of patients (27.5%) with a positive pivot test. Cho SD, Youm YS, Lee CC et-al. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. Correspondence to Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. [17] do not mention whether any patients underwent biopsy (Table 3). Mucoid degeneration of the anterior cruciate ligament. Clin Orthop Surg. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. Please enable it to take advantage of the complete set of features! maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Besides, the patient may also have trouble in moving. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. PubMed Central 2001;30(6):312315. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. in 1999 [1]. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Hide glossary Glossary. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. 2011 Mar;25(3):262-5. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. 2004;182 (5): 1283-7. 2007;245 (3): 916-7. (61years), which was the largest study and represented more than one third of the total patients included in this review. PMC 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Only nine studies met our inclusion criteria and they were all case series. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. 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. Conclusion: Treatment of ACL mucoid degeneration by this modality is effective in preventing recurrence, post-operative laxity and provides better functional outcome compared to the classical partial resection of the degenerated ACL. They respond well to a judicious arthroscopic release of the ACL with notchplasty. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. and transmitted securely. 2011. Arthroscopic findings. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. A long duration of non-specific knee pain in a patient should be evaluated with MRI. It can cause pain and to a meniscal tear. TS designed the project, literature search and wrote the manuscript. 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. 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. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. ACL debridement was partial in all studies except for those by Lintz et al. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients.Materials and MethodsBetween December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis . The aetiology of MDACL is not clearly understood. The extracted data were assessed for meta-analysis. (A) Bulging of the hypertrophied anterior cruciate ligament. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. Epub 2011 Feb 18. Seventeen females (67%) and eight males (33%) were included in the final analysis. Clin Orthop Surg 10(3):307314. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. https://doi.org/10.1302/0301-620X.81B2.0810304, Article Epub 2018 Apr 21. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first described in the literature in 1999.1 Since then, MD-ACL has been recognized as a pathology present on between 0.7% and 5.3% of magnetic resonance images performed for knee pain.2 MD-ACL is thought to be part of a spectrum of ACL disease that can range from ganglion cysts to MD.3 MD-ACL can either be primary (idiopathic . eCollection 2022 May-Jun. 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. Truncation means that the . Orthop Traumatol Surg Res. The rate of simultaneous meniscectomy ranged from 13 to 44%. There was strong association with chondral lesions and meniscal tears. Physical therapy typically begins 7-10 days after the procedure. The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. Mucoid degeneration of the anterior cruciate ligament. However, MDACL is asymptomatic in most patients. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. 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. Conclusions. -, 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. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. Arthroscopic debridement may help relieve the anterior knee pain. Rehabilitation, speech therapy, crenotherapy. It may lead to knee pain. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. All rights reserved. See this image and copyright information in PMC. 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. Epub 2018 Aug 22. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . official website and that any information you provide is encrypted Symptoms included limited range of motion (ROM) and posterior knee pain. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. Epub 2018 Jan 2. official website and that any information you provide is encrypted ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Magn Reson Imaging Clin N Am. Careers. 1992;159(2):35760. 1173185. Other theories include Degenerative theory- MD could occur due to ageing.[3]. -Evaluated and planned treatment protocol in accordance with physician. Postoperative recovery was four weeks on average. 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. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Arthroscopy. Knee Surg Sports Traumatol Arthrosc. This site needs JavaScript to work properly. Would you like email updates of new search results? The site is secure. 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. The origin of MDACL may be degenerative or traumatic. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). Arthroscopic findings. Pan African Medical Journal. Privacy National Library of Medicine The appearance can mimic acute or chronic interstitial partial tears of the ACL. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Part of Sagittal T2-weighted MRI view showing intact anterior, Fig. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Bethesda, MD 20894, Web Policies 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. Mumbai, Maharashtra, India. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. Results: Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. In the nine included studies, four different scores were used for outcome assessment. 1999;81(2):304305. All patients (100%, n=11) reported a good to very good surgery satisfaction. 2011 Aug 1;19(8):1326-33. AJR Am J Roentgenol. The https:// ensures that you are connecting to the Score: 4.7/5 (45 votes) . Accessibility in 1999 [ 1 ]. Download Citation | On Feb 1, 2023, O.R. Arthroscopy. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. At the time the article was last revised Dai Roberts had no recorded disclosures. report that one patient had ACL reconstruction simultaneously after the ACL debridement. 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. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. and Ventura et al. In six of the nine studies [6, 14, 16,17,18], arthroscopic debridement of the ACL was associated with simultaneous partial meniscectomy; this ranged from 13% in the study of Morice et al. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. 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. The appearance can mimic acute or chronic interstitial partial tears of the ACL. 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.
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