4. Results: 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. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. 2013;15(1). By using this website, you agree to our Accessed 1 Mar 2021. Springer Nature. 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. Copyright 2010 Elsevier Masson SAS. Reeducation. Preoperative and postoperative results of eleven patient were compared. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Unable to load your collection due to an error, Unable to load your delegates due to an error. Arthroscopic findings. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Bethesda, MD 20894, Web Policies Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. reported the largest percentage of patients (27.5%) with a positive pivot test. and transmitted securely. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Unauthorized use of these marks is strictly prohibited. Knee Surgery, Sports Traumatology, Arthroscopy. 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. . It results in postoperative laxity, but rarely in frank instability. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Methods: The minimum follow-up was 3 years. (A) Bulging of the hypertrophied anterior cruciate ligament. (B) Partial resection, MeSH The author(s) read and approved the final manuscript. (10%) and highest in the study of Ventura et al. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. 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). Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Patients and methods: what causes mucoid degeneration of acl. https://doi.org/10.1007/s00167-011-1433-0, Article First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Fig. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. PubMedGoogle Scholar. The mean follow up ranged from 13 to 72months. Besides, the patient may also have trouble in moving. J Arthrosc Joint Surg 3(1):2833. government site. 2004;182(5):12831287. 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. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. 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. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. MeSH reported on the co-existence of mucoid degeneration and ganglia of the ACL. 8600 Rockville Pike Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. J Orthop. FOIA The .gov means its official. Dietary management and various treatments Scanning and diagnostic . What is myxoid degeneration treatment? Risk factors Predisposing factors include the following 1: aging Physiotherapy. Papadopoulou P. The celery stalk sign. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. -, Fealy S, Kenter K, Dines JS, Warren RF. National Library of Medicine International Journal of Orthopaedics. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. The retrospective study by Kim et al. When refering to evidence in academic writing, you should always try to reference the primary (original) source. 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. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Epub 2008 Apr 18. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. The https:// ensures that you are connecting to the 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 8600 Rockville Pike Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. 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 . Arthroscopy. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Am J Roentgenol 182(5):12831287. Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. Epub 2018 Aug 22. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. 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. Epub 2013 Aug 27. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms This systematic review has some limitations. Federal government websites often end in .gov or .mil. The patient presented with extension block of the knee. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). 2011. 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). This appearance can mimic acute or chronic interstitial partial tears of the ligament. National Library of Medicine CAS Background: Coronal proton density-weighted magnetic resonance, Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate, Sagittal proton density-weighted magnetic resonance, Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased, Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate, Pre-debridement arthroscopic view showing yellowish. [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, 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.). 8600 Rockville Pike Disclaimer. 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. 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 The appearance can mimic acute or chronic interstitial partial tears of the ACL. FOIA However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. This study concerns complete ACL resec Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. The site is secure. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. The origin of MDACL may be degenerative or traumatic. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. Along with that, it also controls the internal rotation. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. AJR Am J Roentgenol. 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). proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. In the nine included studies, four different scores were used for outcome assessment. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. Before 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. 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. Level of Evidence: Level IV. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. National Library of Medicine The .gov means its official. 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). Physiotherapy. 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). Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. Indian J Orthop 46(5):561565. Bone and joint imaging. This site needs JavaScript to work properly. The cause is not really known, but patients usually do not complain of instability. https://doi.org/10.1016/j.arthro.2003.11.030, Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Online ahead of print. Postoperative pain relief ranged from 53.8 to 95%. Cite this article. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. 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. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). A long duration of non-specific knee pain in a patient should be evaluated with MRI. volume33, Articlenumber:26 (2021) Mucoid degeneration of the anterior cruciate ligament: a case report. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. Epub 2011 Feb 18. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . 2011. The clinical presentation is one of posterior pain with limited flexion. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Epub 2013 Aug 27. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Individuals with mucoid degeneration of the ACL were excluded. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. Arthroscopy 24(6):642649. Conclusions: