Anterior cruciate ligament mucoid degeneration - Radiopaedia Bookshelf The extracted data were assessed for meta-analysis. Accessibility Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. What is acl mucoid degeneration? | HealthTap Online Doctor Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Le signe de la branche de cleri - ResearchGate Epub 2008 Apr 18. Orthopedics; anterior cruciate ligament; arthoscopy. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. 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. 2007;15 (1): 73-86. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. 1173185. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. What is Anterior Cruciate Ligament Mucoid Degeneration? ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Skeletal Radiol. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Mucinous material within the substance of ACL produces pain and limited motion in the knee. There was a high rate of association between degenerative lesions and MDACL, ranging from 39 to 96%. 2012;4 (2): 167-70. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. See this image and copyright information in PMC. (B) Partial resection, MeSH Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. Epub 2018 Jun 13. Multiple theories have been put forth that explains the pathological disorganization in the collagen fibers of the Anterior Cruciate Ligament, such as synovial, traumatic, and degenerative, "Synovial theory- states that there is accumulation of synovial fluid inside the substance of ACL in a herniated pouch of synovium. Level of Evidence: Level IV. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. 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 ]. Patients will . Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. The site is secure. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1302/0301-620X.81B2.0810304, Article The appearance can mimic acute or chronic interstitial partial tears of the ACL. 2. mucoid degeneration of acl mri. Roberts CC, Towers JD, Spangehl MJ et-al. HHS Vulnerability Disclosure, Help We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. 287 (3): 912-921. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Mucoid degeneration of the anterior cruciate ligament. 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. Orthopaedics & Traumatology: Surgery & Research. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. The ligament is mainly responsible for restraining anterior translation of knee. PubMed Methods: The minimum follow-up was 3 years. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Cookies policy. Knee. Bethesda, MD 20894, Web Policies There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). By using this website, you agree to our Conclusions: Mucoid Degeneration of the Anterior Cruciate Ligament: A Case Report Mucoid degeneration of the anterior cruciate ligament - PubMed This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. There is no consensus on treatment and evidence is scarce. 2006;69(9):44952. The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. (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). Anterior cruciate ligament mucoid degeneration: MR findings This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Patients and methods: Orthop Traumatol Surg Res 99(6):693697, Khanna G, Sharma R, Bhardwaj A, Gurdutta HS, Agrawal DK, Rathore AS (2016) Mucoid degeneration of the anterior cruciate ligament: partial arthroscopic debridement and outcomes. AJR Am J Roentgenol. Anterior Cruciate Ligament (ACL) Mucoid Degeneration - Physiopedia The origin of MDACL may be degenerative or traumatic. Sep 2017 - Feb 20186 months. Symptomatic instability was highest in the study of Lintz et al. The inclusion criteria for this study were (1) studies including symptomatic patients with mucoid degeneration of the ACL, (2) studies of 10 or more patients, (3) a minimum of 6months follow up and (4) patients treated conservatively or surgically (arthroscopic debridement with or without simultaneous ACL reconstruction). Noninfiltrating synovial cysts of the ACL were excluded. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. in 1999 [ 1 ]. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Would you like email updates of new search results? ACL MUCOID DEGENERATION RADIOLOGY MRI - Radedasia How to Treat ACL Mucoid Degeneration? - HTQ 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. 2001;30(6):312315. However, MDACL is asymptomatic in most patients. All patients (100%, n=11) reported an improvement in pain. 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. Discussion: AJR Am J Roentgenol. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . 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. Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment Case report: intra-tendinous ganglion of the anterior cruciate ligament 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). 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. . 2007;90(3):1923. The site is secure. 2011. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. Mucoid degeneration of the anterior cruciate ligament: can platelet The rate of association between meniscal tears and MDACL ranged from 9 to 96%. AJR Am J Roentgenol. 1. Epub 2008 Dec 17. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. Chudasama CH, Chudasama VC, Prabhakar MM. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Loreto v. Kijakazi, 1:22-CV-1404-JDG | Casetext Search + Citator National Library of Medicine Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. sharing sensitive information, make sure youre on a federal Level of evidence: Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. -, Fealy S, Kenter K, Dines JS, Warren RF. Would you like email updates of new search results? Papadopoulou P. The celery stalk sign. 2011. NCI CPTC Antibody Characterization Program. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. Eight studies reported postoperative instability. and transmitted securely. Symptomatic ACL mucoid degeneration in middle-age athletes the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. 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. Along with that, it also controls the internal rotation. Ayurvedic treatment for complete acl tear - Practo Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Arch Orthop Trauma Surg. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Resnick D, Kransdorf MJ. AJR Am J Roentgenol. Fourteen knees (48%) had limited flexion, on average 97 degrees. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. (2018) Radiology. 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). ACL Insufficiency | Anterior Knee Instability | Knee Instability https://doi.org/10.1046/j.1445-2197.2003.02748.x, Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a systematic review.
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