Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. Reeducation. 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. 2004;182(5):12831287. (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). See this image and copyright information in PMC. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. 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 ]. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. All rights reserved. 8600 Rockville Pike Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. That is usually the journal article where the information was first stated. 1. 2001;17(9):E37. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). -. Seventeen females (67%) and eight males (33%) were included in the final analysis. 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.). 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. Mucoid degeneration of the anterior cruciate ligament. At the time the article was created Frank Gaillard had no recorded disclosures. 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). Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. (A) Bulging of, Fig. Epub 2018 Aug 22. Knee Surg Sports Traumatol Arthrosc. The total number of patients with symptomatic instability was 18 out of 288 (6%). FOIA To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. Magn Reson Imaging Clin N Am. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Epub 2021 Mar 8. Disclaimer. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. 4. Its signal is increased on all sequences. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Unable to process the form. The clinical presentation is one of posterior pain with limited flexion. Unauthorized use of these marks is strictly prohibited. A 48-year-old-male patient presented with knee pain and limitation of motion. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). 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. official website and that any information you provide is encrypted PROSPERO. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. There is no consensus on treatment and evidence is scarce. When refering to evidence in academic writing, you should always try to reference the primary (original) source. in 1999 [ 1 ]. official website and that any information you provide is encrypted 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. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. An official website of the United States government. 2. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. [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%). 2013;15(1). -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . What causes mucoid degeneration of ACL? Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Radiology. https://doi.org/10.1007/s00167-012-1991-9, McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. AJR Am J Roentgenol. . sharing sensitive information, make sure youre on a federal ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. The retrospective study by Kim et al. A total of 313 knees in 292 patients were included. The aetiology of MDACL is not clearly understood. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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 Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. The .gov means its official. Epub 2010 May 8. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. sharing sensitive information, make sure youre on a federal In most cases Physiopedia articles are a secondary source and so should not be used as references. (10%) and highest in the study of Ventura et al. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Epub 2018 Jun 13. Pain was posterior in 23 knees (80%). Categories were determined in accordance with the study of Ekhtiari et al. JBR-BTR. Mucinous material within the substance of ACL produces pain and limited motion in the knee. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mucoid degeneration of the anterior cruciate ligament. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). J Orthop. Bethesda, MD 20894, Web Policies This site needs JavaScript to work properly. Case report: Methods: Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Orthopedics; anterior cruciate ligament; arthoscopy. 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. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. 2023 BioMed Central Ltd unless otherwise stated. Method. what causes mucoid degeneration of acl. J Knee Surg. 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. Bookshelf The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. 2020 Jun 2. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Mucoid degeneration of the anterior cruciate ligament: a case report. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. Federal government websites often end in .gov or .mil. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. A long duration of non-specific knee pain in a patient should be evaluated with MRI. 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 . Bethesda, MD 20894, Web Policies Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Pandey, Vivek et al. Cite this article. mucoid degeneration of acl mri. Mucoid cystic degeneration of the cruciate ligament. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. Before Fig. Disclaimer. The authors declare that they have no competing interests. [16]. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. 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. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. The mean MINORS score was 9.5 out of 16 (412). The mean MINORS score was 9.5 (range 412). This was lowest in the study of Cha et al. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Second, methodological quality assessment showed that three studies had low methodological quality. Skeletal Radiology. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms volume33, Articlenumber:26 (2021) reported on the co-existence of mucoid degeneration and ganglia of the ACL. National Library of Medicine Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. did not report on this. The .gov means its official. Patients and methods: 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. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Physical therapy typically begins 7-10 days after the procedure. No reconstruction was performed at the same time. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. 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. This site needs JavaScript to work properly. https://doi.org/10.1007/s00167-011-1433-0, Article Orthop Traumatol Surg Res. . Learn how we can help 704 views Reviewed >2 years ago Thank With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst.
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