Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. Methods: Fourteen knees (48%) had limited flexion, on average 97 degrees. Online ahead of print. [6], in 62% of patients (18 of 29) in the study of Lintz et al. 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. 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 . Case report: Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. J Bone Joint Surg Ser B 81(2):304305. Level of evidence: Physiotherapy. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. 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). Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Instrumental treatment. There is no consensus on treatment and evidence is scarce. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. Sep 2017 - Feb 20186 months. GG and AM interpreted the results and reviewed the manuscript. Arthroscopy. -Evaluated and planned treatment protocol in accordance with physician. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. 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). The site is secure. Partial/Total ACL resection arthroscopically- There is marked improvement in the range and reduced posterior pain, but at the cost of increased post-operative knee laxity. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Postoperative symptomatic instability was not common in eight studies, but was observed in 48% of patients in the study of Lintz et al., with two patients having a delayed ACL reconstruction. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Knee Surg Sports Traumatol Arthrosc. Symptoms included limited range of motion (ROM) and posterior knee pain. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Epub 2018 Apr 21. The success of treatment for MDACL and the subsequent risk of instability is not known. . Risk factors Predisposing factors include the following 1: aging The .gov means its official. Open Grey database was searched for grey literature using the same keywords. Unauthorized use of these marks is strictly prohibited. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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. A systematic literature search in the databases MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus was performed through July 2020 by three independent reviewers. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). An official website of the United States government. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Hide glossary Glossary. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. Later studies reported that changes consist of mucoid Results degeneration, neovascularisation, and tendon sheath hyper- Nineteen patients met the inclusion criteria and were inclu- trophy. mucoid degeneration acl symptoms. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. (10%) and highest in the study of Ventura et al. (B) Partial resection, MeSH 1. 2011. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Epub 2021 Nov 24. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. 5. 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). Knee Surg Sports Traumatol Arthrosc. Arthroscopic debridement may help relieve the anterior knee pain. Accessibility Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). 2001;30(6):312315. 2013;15(1). Tamer Sweed. Orthopaedics & Traumatology: Surgery & Research. Arthroscopic findings. 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). Conclusions. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. and transmitted securely. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. 2020 Jun 2. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Mucoid degeneration of the anterior cruciate ligament: a case report. Categories were determined in accordance with the study of Ekhtiari et al. 2023 BioMed Central Ltd unless otherwise stated. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. and transmitted securely. PMC Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity that has been found in patients with pain and limited range of motion of the knee in association with a bulky ACL shown on magnetic resonance imaging (MRI). Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Bethesda, MD 20894, Web Policies Individuals with mucoid degeneration of the ACL were excluded. Before -, Fealy S, Kenter K, Dines JS, Warren RF. Epub 2018 Jan 2. Along with that, it also controls the internal rotation. Pandey, Vivek et al. https://doi.org/10.1302/0301-620X.81B2.0810304, Article J Orthop. The extracted data were assessed for meta-analysis. 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. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. https://doi.org/10.1007/s00167-012-1991-9, McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Part of Any discrepancy was resolved by the senior author. 2. Advanced MR imaging of the cruciate ligaments. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. The mean follow up ranged from 13 to 72months. An official website of the United States government. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. 1999;81(2):304305. Morice et al. Anterior Cruciate Ligament, is an important structure of the knee joint. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. The site is secure. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. Skelet Radiol 30(6):312315. AJR Am J Roentgenol. It can cause pain and to a meniscal tear. government site. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. FOIA A positive Lachman test and a negative pivot shift were noted after surgery in all cases. . The ligament is mainly responsible for restraining anterior translation of knee. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Epub 2018 Jun 13. Epub 2018 Aug 22. Clin Orthop Surg 10(3):307314. The origin of MDACL may be degenerative or traumatic. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Arthroscopy. Ligaments are very tough, fibrous tissue structures. sharing sensitive information, make sure youre on a federal Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). https://doi.org/10.4103/0019-5413.128765, Article 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. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. in 1999 [ 1 ]. PubMed 1). Unauthorized use of these marks is strictly prohibited. Knee Surg Sports Traumatol Arthrosc. Epub 2011 Feb 18. The site is secure. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Check for errors and try again. Methods: The minimum follow-up was 3 years. The mean MINORS score was 9.5 out of 16 (412). official website and that any information you provide is encrypted Would you like email updates of new search results? proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. AJR Am J Roentgenol. . Arthroscopy 24(6):642649. 3. All rights reserved. Federal government websites often end in .gov or .mil. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. 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]. Symptomatic ACL mucoid degeneration in middle-age athletes.