statement and government site. Federal government websites often end in .gov or .mil. Four studies reported only postoperative scores, which were comparable to those in other studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. HHS Vulnerability Disclosure, Help and transmitted securely. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. California Privacy Statement, 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. Symptoms included limited range of motion (ROM) and posterior knee pain. However, the authors did not report whether there were any other patients with symptomatic instability. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. See this image and copyright information in PMC. Mucoid degeneration of the anterior cruciate ligament. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Therefore, indications for ACL resection must be carefully selected. Indian J Orthop. Arch Orthop Trauma Surg. FOIA Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. 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. Physiotherapy. 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. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. Level of evidence: Accessibility Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. The presence of intraligamentous mucoid degeneration in the ACL is demonstrated as a source of knee pain without instability and partial ACL debridement did not preclude adequate knee stability. Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. Arthroscopic debridement of the ACL resulted in good pain relief and improved range of movement in all studies, with postoperative improvement in the knee scores. Clin Orthop Surg. The mean follow up ranged from 13 to 72months. ANZ J Surg 73(9):712716. J Chin Med Assoc. eCollection 2022 May-Jun. Case report: Physical therapy typically begins 7-10 days after the procedure. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. J Arthrosc Joint Surg 3(1):2833. PROSPERO. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. The retrospective study by Kim et al. Tamer Sweed. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. 1. Bookshelf This site needs JavaScript to work properly. 1 Its prevalence in magnetic resonance imaging (MRI) is 1.8-5.3%, but not all lesions are symptomatic.2, 3 It is characterized by infiltration of mucoid-like substance (glycosaminoglycans) interspersed within the Would you like email updates of new search results? The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Mucoid degeneration of both ACL and PCL. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Clipboard, Search History, and several other advanced features are temporarily unavailable. Conclusions: : A Meta-Analysis. Bethesda, MD 20894, Web Policies Physical Therapy. 8600 Rockville Pike An official website of the United States government. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Method. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. . 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. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Conditions that resembles the clinical findings are: Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. National Library of Medicine Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. J Orthop. Postoperative recovery was four weeks on average. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. Only nine studies met our inclusion criteria and they were all case series. Seventeen females (67%) and eight males (33%) were included in the final analysis. There is no consensus on treatment and evidence is scarce. 2018. http://journals.sagepub.com/doi/10.1177/2325967118786930, Pandey V, Suman C, Sharma S, Rao SP, Kiran Acharya K, Sambaji C (2014) Mucoid degeneration of the anterior cruciate ligament: management and outcome. 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. 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). Level of Evidence: Level IV. 2. Twelve partial and 17 total resections were performed. Methods: The minimum follow-up was 3 years. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. HHS Vulnerability Disclosure, Help Cite this article. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Hypothesis: Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. 2011. Anterior cruciate ligament mucoid degeneration. This was lowest in the study of Cha et al. Categories were determined in accordance with the study of Ekhtiari et al. GG and AM interpreted the results and reviewed the manuscript. Characteristic: "celery stalk" appearance. 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. official website and that any information you provide is encrypted Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. The appearance can mimic acute or chronic interstitial partial tears of the ACL. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. Questions just answered: mucoid degeneration of acl physiotherapy. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. They respond well to a judicious arthroscopic release of the ACL with notchplasty. The site is secure. https://doi.org/10.1016/j.jclinepi.2009.06.005. Careers. This site needs JavaScript to work properly. All nine studies were case series; six were retrospective and three were prospective studies. Keywords: The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. 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). Knee Surgery & Related Research Clin Orthop Surg. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Mucoid degeneration of the anterior cruciate ligament. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. Any discrepancy was resolved by the senior author. The mean MINORS score was 9.5 out of 16 (412). Arthroscopy. All nine studies assessed the outcome of arthroscopic debridement of MDACL. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. 2011 Mar;25(3):262-5. It results in postoperative laxity, but rarely in frank instability. (A) Bulging of, Fig. The .gov means its official. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. Am J Roentgenol 182(5):12831287. Bergin D, Morrison WB, Carrino JA et-al. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. 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. Bethesda, MD 20894, Web Policies This is a rare pathological condition, in which, there is increased signal from within the ligament. HHS Vulnerability Disclosure, Help The https:// ensures that you are connecting to the The reported restriction of range of movement was flexion deficit in four studies [3, 13, 15, 17], extension deficit in one study [14] and combined flexion and extension deficit in four studies [6, 16, 18, 19] (Table4). Anterior knee pain is the more common complaint. Ventura et al. . Careers. National Library of Medicine 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. What Is Mucoid Degeneration of the ACL? 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. 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. Read More Created for people with ongoing healthcare needs but benefits everyone. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. An official website of the United States government. 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. Accessed 1 Mar 2021. government site. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Glossary of terms for musculoskeletal radiology. Bone and joint imaging. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. National Library of Medicine All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. Postoperative pain relief ranged from 53.8 to 95%. 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. In most cases Physiopedia articles are a secondary source and so should not be used as references. -, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK. eCollection 2021. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. Pan African Medical Journal. Accessibility 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 1999;81(2):304305. 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. Fig. and Ventura et al. The minimum follow-up was 3 years.
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