J Sports Med Phys Fitness 48(4):483487, PubMed Knee Surg Sports Traumatol Arthrosc. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. 2012;4 (2): 167-70. Mucoid Degeneration of the Anterior Cruciate Ligament - ResearchGate Before Knee Surg Sports Traumatol Arthrosc 19(8):13261333. and transmitted securely. What Is Mucoid Degeneration of the ACL? In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. 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. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. The authors declare that they have no competing interests. Signal intensity of the anteromedial bundle (AMB) or posterolateral bundle (PLB) graft standardized to the intensity of the PCL was defined as signal intensity ratio (SIR). Fourteen knees (48%) had limited flexion, on average 97 degrees. mucoid degeneration of acl mri. Check for errors and try again. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. mucoid degeneration acl symptoms. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Accessibility Epub 2018 Jan 2. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. It results in postoperative laxity, but rarely in frank instability. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. ACL Insufficiency | Anterior Knee Instability | Knee Instability 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. Anterior cruciate ligament mucoid degeneration: Selecting the best Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. Arch Orthop Trauma Surg. They respond well to a judicious arthroscopic release of the ACL with notchplasty. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Twelve partial and 17 total resections were performed. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. 1. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. 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. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. MM and A performed the literature search, and data analysis. Bergin D, Morrison WB, Carrino JA et-al. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. ADVERTISEMENT: Supporters see fewer/no ads. This appearance can mimic acute or chronic interstitial partial tears of the ligament. (A) Bulging of, Fig. (61years), which was the largest study and represented more than one third of the total patients included in this review. report that one patient had ACL reconstruction simultaneously after the ACL debridement. 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. A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Anterior Cruciate Ligament (ACL) Mucoid Degeneration - Physiopedia Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. The site is secure. 2001;30(6):312315. 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 The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. 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. Bergin et al. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. An official website of the United States government. 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. Knee Surg Sports Traumatol Arthrosc. Manage cookies/Do not sell my data we use in the preference centre. Mucoid degeneration of the anterior cruciate ligament: Partial 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. Symptomatic instability was highest in the study of Lintz et al. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. 2011 Mar;25(3):262-5. 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. Indian J Orthop. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Score: 4.7/5 (45 votes) . 2011. in 1999 [ 1 ]. 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). https://doi.org/10.4103/0019-5413.128765, Article This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. HHS Vulnerability Disclosure, Help Would you like email updates of new search results? Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. and transmitted securely. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . (A) Bulging of the hypertrophied anterior cruciate ligament. 2011. 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. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the (10%) and highest in the study of Ventura et al. eCollection 2021. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. However, MDACL is asymptomatic in most patients. Anterior cruciate ligament mucoid degeneration: a review of the 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. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). Radiology. Method. Arthroscopic treatment of mucoid degeneration of the anterior cruciate 8600 Rockville Pike What is acl mucoid degeneration? | HealthTap Online Doctor FOIA 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. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. MeSH Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Mucoid degeneration itself is described as a yellow or brown substance which can be either seen through the most anterior fibers of the ACL or found by probing between them [ 19, 35] (Fig. reported the largest percentage of patients (27.5%) with a positive pivot test. 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. The https:// ensures that you are connecting to the Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. https://doi.org/10.1016/j.jclinepi.2009.06.005. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Partial Anterior Cruciate Ligament - ACL - Tears - Howard J. Luks, MD Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. National Center for Biotechnology Information Accessibility Each study was scored 02 on each question, with a global ideal score of 16. Arthroscopy. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. 1173185. 2007;90(3):1923. . Federal government websites often end in .gov or .mil. What does mucoid degeneration of posterior horn of medial - HealthTap volume33, Articlenumber:26 (2021) Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. Unauthorized use of these marks is strictly prohibited. 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. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Mucoid degeneration of the anterior cruciate ligament. Four studies reported only postoperative scores, which were comparable to those in other studies. 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 . Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. The quality of methodology was excellent in one study, good in five studies, low in two studies and very low in one study (Tables 1 and 2). Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. eCollection 2022 May-Jun. Indian J Orthop 48(2):197202. reported on the co-existence of mucoid degeneration and ganglia of the ACL. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. This is a rare pathological condition, in which, there is increased signal from within the ligament. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Arthroscopic findings. 2010 Jun 1;96(4):400-6. 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. . Introduction: Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. (Table 3). and transmitted securely. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). 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 ). Mucoid degeneration of anterior cruciate ligament (ACL) A long duration of non-specific knee pain in a patient should be evaluated with MRI. TS designed the project, literature search and wrote the manuscript. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Symptomatic ACL mucoid degeneration in middle-age athletes. A total of 313 knees in 292 patients were included in the nine studies. National Library of Medicine Therefore, indications for ACL resection must be carefully selected. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 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. Anterior cruciate ligament mucoid degeneration: MR findings 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). As there was no control group in any of the studies and the natural history of MDACL is not known, the postoperative improvement may have been attributed to the placebo effect, simultaneous arthroscopic procedures or the postoperative rehabilitation, or may be due to the pain having resolved without treatment at all. sharing sensitive information, make sure youre on a federal 2011 Jun;25(6):650-2. Postoperative clinical laxity was common, however, symptomatic instability was not. PDF Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration: A Review Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. . All patients (100%, n=11) reported a good to very good surgery satisfaction. Sagittal T2-weighted MRI view showing intact anterior, Fig. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. 2. what causes mucoid degeneration of acl. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Epub 2010 May 8. [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%). However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Mucoid degeneration of the anterior cruciate ligament. -Evaluated and planned treatment protocol in accordance with physician. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. 2023 BioMed Central Ltd unless otherwise stated. The https:// ensures that you are connecting to the Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Chudasama et al. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. 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. Joshita Poojary - Sports Physical Therapist - Padmanabhan's - Linkedin Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. J Clin Epidemiol 62(10):10061012. Mucoid degeneration of ACL - Osteoporosis - inspire.com Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate MDACL is differentiated from synovial cysts of the anterior cruciate ligament (ACL) where, in MDACL, mucoid tissue intermingles within ACL fibres and is not contained within a cyst [3]. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Unable to load your collection due to an error, Unable to load your delegates due to an error. This systematic review has some limitations. The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. official website and that any information you provide is encrypted The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. 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. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Mucoid degeneration of the anterior cruciate ligament 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. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. Its function is to stabilize the knee while bending and rotating; the ACL also keeps the knee from shifting out of place or moving anteriorly (toward the front) with pivoting activities. [6], in 62% of patients (18 of 29) in the study of Lintz et al. Epub 2011 Feb 18. Epub 2018 Apr 21. Does mucoid degeneration of ACL require surgery? - TimesMojo 2. How to Treat ACL Mucoid Degeneration? - HTQ Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Clinical Outcomes, Return to Sports, and Patient Satisfaction After Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients in an Asian Population-A 2-Year Follow-up Study. It can cause pain and to a meniscal tear. 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. 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). Accessibility Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. In most cases Physiopedia articles are a secondary source and so should not be used as references. Arch Orthop Trauma Surg. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. 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. Knee. PROSPERO. Knee Surgery, Sports Traumatology, Arthroscopy. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . Copyright 2010 Elsevier Masson SAS. Dietary management and various treatments Scanning and diagnostic . The mean follow up ranged from 13 to 72months. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 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. Accessibility Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. 2007;15 (1): 73-86. 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. Management of mucoid degeneration of the anterior cruciate ligament: a J Chin Med Assoc. Anterior knee pain is the more common complaint. Characteristic: "celery stalk" appearance. CAS Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Before 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 ]. PMC 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. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. 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. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. 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. Pan African Medical Journal. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms.