CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Chudasama et al. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Epub 2011 Feb 18. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Conclusions. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Magn Reson Imaging Clin N Am. We report a case of a patient with mucoid degeneration of the ACL, presenting with posterior knee pain and no history of a major knee trauma. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). Preoperative magnetic resonance imaging (MRI), Fig. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Orthopedics; anterior cruciate ligament; arthoscopy. 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. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. J Chin Med Assoc. 2. what causes mucoid degeneration of acl. ACL tears don't heal as such. Characteristic: "celery stalk" appearance. The total number of patients with symptomatic instability was 18 out of 288 (6%). What Is Mucoid Degeneration of the ACL? 2004;182(5):12837. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. 2001;30(6):312315. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. The origin of MDACL may be degenerative or traumatic. National Library of Medicine Anterior cruciate ligament mucoid degeneration. (B) Partial resection, MeSH Ventura et al. What is Anterior Cruciate Ligament Mucoid Degeneration? The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Symptomatic ACL mucoid degeneration in middle-age athletes. 2004;182 (5): 1283-7. volume33, Articlenumber:26 (2021) Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. An official website of the United States government. This site needs JavaScript to work properly. Cite this article. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Physiotherapy. https://doi.org/10.4103/0019-5413.128765, Article 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). Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate 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). Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. The site is secure. 8600 Rockville Pike 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. A total of 313 knees in 292 patients were included. 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. had the largest number of patients (91) with a mean age of 61 years, which was the oldest study population amongst the nine studies [16]. 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). Orthopaedics & Traumatology: Surgery & Research. Mucoid degeneration of the anterior cruciate ligament (ACL) is regarded as a degenerative change in the ligament, which is clinically presented with pain on full extension or flexion in the middle-aged population. 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 ]. Risk factors Predisposing factors include the following 1: aging It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. 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. and transmitted securely. Physical Therapy. AJR Am J Roentgenol. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. . Khanna et al. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Bone and joint imaging. NCI CPTC Antibody Characterization Program. https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. A total of nine studies were eligible for review. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). eCollection 2022 May-Jun. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). sharing sensitive information, make sure youre on a federal Method. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Accessibility Arthroscopy. 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. 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. Discussion: No reconstruction was performed at the same time. https://doi.org/10.1016/j.jclinepi.2009.06.005. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. This is a rare pathological condition, in which, there is increased signal from within the ligament. [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%). -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Learn how we can help 704 views Reviewed >2 years ago Thank Disclaimer. ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. 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. eCollection 2013. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. 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. Arch Orthop Trauma Surg. Epub 2013 Aug 27. TS designed the project, literature search and wrote the manuscript. and transmitted securely. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. CAS 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. Epub 2010 May 8. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Unable to load your collection due to an error, Unable to load your delegates due to an error. Case report: Keywords: 3. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. [Diagnosis and treatment of anterior cruciate ligament cysts]. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. There was more than 20% loss to follow up in the study of Kim et al., while the three prospective studies had no loss to follow up [13, 14, 18]. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. The .gov means its official. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. 1). Results: Arthroscopic diagnostic criteria [7] are (1) continuous ACL fibres, (2) increased ACL volume, (3) yellowish-coloured material expressed on palpation and (4) loss of ACL synovial lining. -Evaluated and planned treatment protocol in accordance with physician. Would you like email updates of new search results? A 48-year-old-male patient presented with knee pain and limitation of motion. The mean age of patients ranged from 31 to 78years. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. Patients and methods: The knee is a complex synovial joint that can be affected by a range of pathologies: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. 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. The clinical presentation is one of posterior pain with limited flexion. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. 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. Bergin et al. There is no consensus on treatment and evidence is scarce. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). Epub 2011 Feb 18. Anterior Cruciate Ligament, is an important structure of the knee joint. . The https:// ensures that you are connecting to the Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL.

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