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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. The clinical presentation is one of posterior pain with limited flexion. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Careers. Results: 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). The authors declare that they have no competing interests. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. . HHS Vulnerability Disclosure, Help Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. The success of treatment for MDACL and the subsequent risk of instability is not known. 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. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. sharing sensitive information, make sure youre on a federal However, MDACL is asymptomatic in most patients. Bookshelf Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. 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). Fourteen knees (48%) had limited flexion, on average 97 degrees. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. FOIA Glossary of terms for musculoskeletal radiology. It results in postoperative laxity, but rarely in frank instability. Instrumental treatment. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. Questions just answered: mucoid degeneration of acl physiotherapy. The mean age at the time of surgery was 57 years (range, 31 to 78 years). official website and that any information you provide is encrypted 4. Orthop Traumatol Surg Res. . Other theories include Degenerative theory- MD could occur due to ageing.[3]. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . No treatment is usually required. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. J Bone Joint Surg Br. Level of evidence: Federal government websites often end in .gov or .mil. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. A total of 313 knees in 292 patients were included in the nine studies. The retrospective study by Kim et al. At the time the article was created Frank Gaillard had no recorded disclosures. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. 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. . Knee. 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. Ventura et al. PROSPERO. 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. However, symptomatic instability was not common. 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). Eight studies reported postoperative instability. ACL tears don't heal as such. At the time the article was last revised Dai Roberts had no recorded disclosures. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Its signal is increased on all sequences. [Diagnosis and treatment of anterior cruciate ligament cysts]. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 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. On clinical examination, the active range of motion showed a flexion deficit. AJR Am J Roentgenol. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. : A Meta-Analysis. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Any discrepancy was resolved by the senior author. 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. This systematic review has some limitations. Unable to load your collection due to an error, Unable to load your delegates due to an error. National Library of Medicine Unauthorized use of these marks is strictly prohibited. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. 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). The origin of MDACL may be degenerative or traumatic. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. 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. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. In the nine included studies, four different scores were used for outcome assessment. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Indian J Orthop. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Keywords: Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. The rate of simultaneous meniscectomy ranged from 13 to 44%. (10%) and highest in the study of Ventura et al. Results: All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. Arthroscopy. ACL debridement was partial in all studies except for those by Lintz et al. 2010 Jun 1;96(4):400-6. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. 2001;30(6):312315. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. This site needs JavaScript to work properly. J Chin Med Assoc. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. official website and that any information you provide is encrypted 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). This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Mucoid degeneration of the anterior cruciate ligament. in 1999 [1]. Radiology. AJR Am J Roentgenol. 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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. Springer Nature. Morice et al. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. 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. The site is secure. 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. 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. The https:// ensures that you are connecting to the Skeletal Radiol. Unable to load your collection due to an error, Unable to load your delegates due to an error. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Clin Orthop Surg 10(3):307314. 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. Conclusions. Chudasama et al. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. The ligament is mainly responsible for restraining anterior translation of knee. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). Sagittal T2-weighted MRI view showing intact anterior, Fig. Skeletal Radiology. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. 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 ). Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Knee Surg Sports Traumatol Arthrosc. sharing sensitive information, make sure youre on a federal The https:// ensures that you are connecting to the The patient presented with extension block of the knee. AJR Am J Roentgenol. -. [17] do not mention whether any patients underwent biopsy (Table 3). Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. The https:// ensures that you are connecting to the Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid No reconstruction was performed at the same time. This may support the theory that it is a degenerative process. Partial/Total ACL resection arthroscopically- There is marked improvement in the range and reduced posterior pain, but at the cost of increased post-operative knee laxity. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. PubMed HHS Vulnerability Disclosure, Help Unauthorized use of these marks is strictly prohibited. Epub 2018 Aug 22. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Rehabilitation, speech therapy, crenotherapy. Check for errors and try again. Arthroscopy. 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. Cite this article. 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. 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. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Pan African Medical Journal. A 48-year-old-male patient presented with knee pain and limitation of motion. Conclusions 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 . 8600 Rockville Pike The .gov means its official. 2011 Jun;25(6):650-2. GG and AM interpreted the results and reviewed the manuscript. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. ADVERTISEMENT: Supporters see fewer/no ads. Therefore, indications for ACL resection must be carefully selected. Terms and Conditions, I get PT and acupuncture, have had several epidural injections, and am trying hard to avoid osteoporosis meds (was on bisphosphonates for many years many years ago) as well as spinal fusion.