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. Arthroscopy 24(6):642649. All patients (100%, n=11) reported an improvement in pain. 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. 1. 1. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. Would you like email updates of new search results? The anterior cruciate ligament (ACL) is an important ligament in the knee. Epub 2018 Jan 2. J Chin Med Assoc. Indian J Orthop 46(5):561565. 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. in 1999 [ 1 ]. Glossary of terms for musculoskeletal radiology. 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. NCI CPTC Antibody Characterization Program. J Chin Med Assoc. https://doi.org/10.1302/0301-620X.81B2.0810304, Article See this image and copyright information in PMC. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. . Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Epub 2011 Feb 18. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Physiotherapy. Symptomatic instability was highest in the study of Lintz et al. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Mumbai, Maharashtra, India. Preoperative magnetic resonance imaging (MRI) scan. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Please enable it to take advantage of the complete set of features! Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. 4. However, MDACL is asymptomatic in most patients. California Privacy Statement, Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Risk factors Predisposing factors include the following 1: aging (A) Bulging of, Fig. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? The origin of MDACL may be degenerative or traumatic. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Chudasama et al. This systematic review has some limitations. [6], in 62% of patients (18 of 29) in the study of Lintz et al. However, the authors did not report whether there were any other patients with symptomatic instability. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. HHS Vulnerability Disclosure, Help Disclaimer. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Arthroscopy. Ventura et al. There is no consensus on treatment and evidence is scarce. Careers. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Individuals with mucoid degeneration of the ACL were excluded. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. 2004;182(5):12837. The site is secure. Learn how we can help 704 views Reviewed >2 years ago Thank Case report: AJR Am J Roentgenol. This appearance can mimic acute or chronic interstitial partial tears of the ligament. This may support the theory that it is a degenerative process. Correspondence to This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. It results in postoperative laxity, but rarely in frank instability. Bookshelf Knee Surg Sports Traumatol Arthrosc. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. All patients (100%, n=11) reported a good to very good surgery satisfaction. Arthroscopic findings. See this image and copyright information in PMC. : A Meta-Analysis. 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. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. No treatment is usually required. and transmitted securely. Conditions that resembles the clinical findings are: Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. Knee Surg Sports Traumatol Arthrosc. The total number of patients with symptomatic instability was 18 out of 288 (6%). The ligament is mainly responsible for restraining anterior translation of knee. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Anterior knee pain is the more common complaint. . Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. Mucinous material within the substance of ACL produces pain and limited motion in the knee. 2011. 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. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Accessed 1 Mar 2021. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. mucoid degeneration acl symptoms. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Terms and Conditions, Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. government site. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. https://doi.org/10.4055/cios.2018.10.3.307, University Hospitals of Derby and Burton, Uttoxeter Rd, Derby, DE22 3NE, UK, Trauma and Orthopaedic Speciality Trainee, West Midlands Deanery, Birmingham Rotation, Birmingham, UK, University Hospitals Plymouth NHS Trust, Plymouth, UK, University of Alexandria, Alexandria, Egypt, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry, CV2 2DX, UK, You can also search for this author in in 1999 [ 1 ]. Bethesda, MD 20894, Web Policies J Clin Epidemiol 62(10):10061012. Bookshelf Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). Epub 2008 Dec 17. 2. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Would you like email updates of new search results? mucoid degeneration of acl mri. 2018;4(4):875-80. [16]. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Clinical outcome was reported using a variety of scores (the Lysholm and International Knee Documentation Committee (IKDC) score, the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the visual analogue scale (VAS) score) in the different studies; these are summarized in Table 4. Chudasama CH, Chudasama VC, Prabhakar MM. sharing sensitive information, make sure youre on a federal 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]. 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). PMC Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Results: All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. 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. 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. Online ahead of print. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review.
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