";s:4:"text";s:20576:"Read More Created for people with ongoing healthcare needs but benefits everyone. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Therefore, indications for ACL resection must be carefully selected. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. J Chin Med Assoc. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Please enable it to take advantage of the complete set of features! I have persistent pain in the back of that knee that is exacerbated by walking and bending it. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. 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]. Provided by the Springer Nature SharedIt content-sharing initiative. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. National Library of Medicine Arch Orthop Trauma Surg. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients.Materials and MethodsBetween December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis . -, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Indian J Orthop 48(2):197202. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. 8600 Rockville Pike 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. The origin of MDACL may be degenerative or traumatic. Papadopoulou P. The celery stalk sign. Questions just answered: mucoid degeneration of acl physiotherapy. Indian J Orthop. sharing sensitive information, make sure youre on a federal Anterior cruciate ligament mucoid degeneration. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. 2011. 2018;4(4):875-80. A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. The .gov means its official. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. https://doi.org/10.1016/j.arthro.2008.02.004, Morice A, Coupry A, Lintz F, Robert H (2013) Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Mucoid degeneration of ACL. 2011. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Federal government websites often end in .gov or .mil. Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased signal intensity and a celery stalk appearance of intact fibers. official website and that any information you provide is encrypted 2007;90(3):1923. and transmitted securely. Truncation means that the . Methods: The minimum follow-up was 3 years. PubMed -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. 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. The https:// ensures that you are connecting to the Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Epub 2010 May 8. Epub 2021 Mar 8. Clipboard, Search History, and several other advanced features are temporarily unavailable. Bone and joint imaging. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Cho SD, Youm YS, Lee CC et-al. 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. Epub 2018 Jan 2. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. The author(s) read and approved the final manuscript. All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Accessibility Federal government websites often end in .gov or .mil. Introduction: 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.). This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. Would you like email updates of new search results? Mucoid degeneration of the anterior cruciate ligament. See this image and copyright information in PMC. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. 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. . Only nine studies met our inclusion criteria and they were all case series. J Knee Surg. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-3615, Case 11: with Hoffa fat pad ganglion cyst, Case 12: tibial nerve schwannoma and ACL mucoid degeneration, Case 1: Complete ACL tear and meniscal tears, Case 2: Anomalous insertion of the medial meniscus, View Frank Gaillard's current disclosures, see full revision history and disclosures, anterior cruciate ligament ganglion cysts, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Mucoid degeneration of the anterior cruciate ligament, congenital or acquired synovial tissue entrapment between ACL fibers. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 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. government site. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42018087782). Skelet Radiol 30(6):312315. This study concerns complete ACL resec Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee 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 PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Mucoid degeneration of the anterior cruciate ligament. W B Saunders Co. (2005) ISBN:0721602703. -. Arthroscopy. 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. 1992;159(2):35760. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Results: Preoperative and postoperative results of eleven patient were compared. Federal government websites often end in .gov or .mil. The aetiology of MDACL is not clearly understood. Sagittal T2-weighted MRI view showing intact anterior, Fig. 2004;182 (5): 1283-7. Would you like email updates of new search results? CAS official website and that any information you provide is encrypted "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. 2013;15(1). 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. All nine studies assessed the outcome of arthroscopic debridement of MDACL. The mean age of patients ranged from 31 to 78years. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Accessibility Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 287 (3): 912-921. Arthroscopy. 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. 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. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Intact fibers are best seen on T2WI. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. government site. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . International Journal of Orthopaedics. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. This appearance can mimic acute or chronic interstitial partial tears of the ligament. MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. Case report: It may lead to knee pain. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. Terms and Conditions, Please enable it to take advantage of the complete set of features! FOIA Orthopedics; anterior cruciate ligament; arthoscopy. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. 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). Online ahead of print. [16]. Careers. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). The site is secure. 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). Disclaimer. [6], in 62% of patients (18 of 29) in the study of Lintz et al. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. 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 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. The .gov means its official. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Roberts CC, Towers JD, Spangehl MJ et-al. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Careers. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. government site. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. 2011. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. 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. Mucinous material within the substance of ACL produces pain and limited motion in the knee. 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 ]. 2007;245 (3): 916-7. Khanna et al. 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. mucoid degeneration of acl mri. Bookshelf official website and that any information you provide is encrypted Conclusions. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Symptomatic ACL mucoid degeneration in middle-age athletes. A total of nine studies were eligible for review. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. A long duration of non-specific knee pain in a patient should be evaluated with MRI. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. The mean follow up ranged from 13 to 72months. You can read more if you want. Arthroscopic findings. 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. Score: 4.7/5 (45 votes) . government site. 2004;182(5):12837. Clipboard, Search History, and several other advanced features are temporarily unavailable. Ligaments and tendons are accumulated by mucoid change might display a thickened and/or hypertrophied appearance, with an increase in signal intensity. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. in 1999 [ 1 ]. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. Bethesda, MD 20894, Web Policies Average improvement in flexion was 21.5 degrees (0 to 60 degrees). 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. Level of evidence: The https:// ensures that you are connecting to the Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). Unable to process the form. 8600 Rockville Pike J Orthop. Postoperative pain relief ranged from 53.8 to 95%. Physical therapy typically begins 7-10 days after the procedure. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Mucoid cystic degeneration of the cruciate ligament. Categories were determined in accordance with the study of Ekhtiari et al. Average patient age was 49 (22 to 68) years. https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Arthroscopy. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. FOIA statement and 2011 Jun;25(6):650-2. Therefore, indications for ACL resection must be carefully selected. Would you like email updates of new search results? 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. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. The anterior cruciate ligament (ACL) is an important ligament in the knee. J Bone Joint Surg Ser B 81(2):304305. https://doi.org/10.4103/0019-5413.101037, Srivastava A, Pateliya S, Singh H, Aggarwal S, Srivastava S (2016) Mucoid degeneration of anterior cruciate ligament management and functional outcome of 18 cases. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. 2023 BioMed Central Ltd unless otherwise stated. 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. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. ";s:7:"keyword";s:40:"mucoid degeneration of acl physiotherapy";s:5:"links";s:1080:"Peter Scott Obituary New Brunswick,
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