Clin Orthop Surg. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). 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). This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). This ranged from 90 to 95% in all studies, except in the report by Kim et al., where only 53.8% of patients (57/106) had complete pain relief after surgery. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. 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. However, symptomatic instability was not common. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. Orthop Traumatol Surg Res. The .gov means its official. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. 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. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Other theories include Degenerative theory- MD could occur due to ageing.[3]. Federal government websites often end in .gov or .mil. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Background: Along with that, it also controls the internal rotation. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. At the time the article was last revised Dai Roberts had no recorded disclosures. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate Knee Surg Sports Traumatol Arthrosc. Skelet Radiol 30(6):312315. An official website of the United States government. The success of treatment for MDACL and the subsequent risk of instability is not known. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Clin Orthop Surg. sharing sensitive information, make sure youre on a federal The minimum follow-up was 3 years. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. No reconstruction was performed at the same time. There was strong association between degenerative changes and MDACL (82% having chondral and 69% meniscal lesions), which might suggest that MDACL is a degenerative process. The author(s) read and approved the final manuscript. mucoid degeneration of acl mri. Online ahead of print. Unauthorized use of these marks is strictly prohibited. Discussion: Please enable it to take advantage of the complete set of features! Mucoid degeneration of the anterior cruciate ligament. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. By using this website, you agree to our Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Patient having mucoid degeneration of ACL seeks multiple orthopedic consultation and most of the time treating orthopedican miss its diagnosis either because of lack of experience or rare cause of pain unless doctor sought magnetic resonance imaging (MRI) of knee. MM and A performed the literature search, and data analysis. Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Epub 2013 Aug 27. Careers. Pan African Medical Journal. ADVERTISEMENT: Supporters see fewer/no ads. 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. The mean follow up ranged from 13 to 72months. Besides, the patient may also have trouble in moving. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. J Bone Joint Surg Ser B 81(2):304305. Each study was scored 02 on each question, with a global ideal score of 16. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Seventeen females (67%) and eight males (33%) were included in the final analysis. The site is secure. eCollection 2022 May-Jun. (2018) Radiology. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Knee Surg Sports Traumatol Arthrosc. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). ACL tears don't heal as such. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Int J Curr Res Aca Rev 4(11):1824 http://www.ijcrar.com/abstractview.php?ID=228&vol=4-11-2016&SNo=3, Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI (2008) Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. J Chin Med Assoc. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. -, Fealy S, Kenter K, Dines JS, Warren RF. Epub 2008 Apr 18. This may support the theory that it is a degenerative process. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Learn how we can help 704 views Reviewed >2 years ago Thank Clipboard, Search History, and several other advanced features are temporarily unavailable. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. Careers. and Ventura et al. 2011. Knee Surgery & Related Research 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. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. 4. Physical Therapy. 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. Symptoms included limited range of motion (ROM) and posterior knee pain. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Pandey, Vivek et al. First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. The https:// ensures that you are connecting to the #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. and transmitted securely. This systematic review has some limitations. Tamer Sweed. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. The mean follow up ranged from 13 to 72months. Ligaments are very tough, fibrous tissue structures. 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. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. CAS 2006;69(9):44952. There is no consensus on treatment and evidence is scarce. https://doi.org/10.1016/j.jclinepi.2009.06.005. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. : A Meta-Analysis. You can read more if you want. It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). The site is secure. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Arthroscopic findings. ANZ J Surg 73(9):712716. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Would you like email updates of new search results? Second, methodological quality assessment showed that three studies had low methodological quality. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first described in the literature in 1999.1 Since then, MD-ACL has been recognized as a pathology present on between 0.7% and 5.3% of magnetic resonance images performed for knee pain.2 MD-ACL is thought to be part of a spectrum of ACL disease that can range from ganglion cysts to MD.3 MD-ACL can either be primary (idiopathic . Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. IV (retrospective cohort study). Before Orthopedics; anterior cruciate ligament; arthoscopy. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. 2004;182 (5): 1283-7. In most cases Physiopedia articles are a secondary source and so should not be used as references. Mucoid degeneration of ACL Justamom21 Feb 17, 2023 7:27 AM Among other conditions - osteoarthritis, osteopenia, spondylolisthesis- an MRI report showed "severe mucoid degeneration of the ACL" in my left knee. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. in 1999 [ 1 ]. Federal government websites often end in .gov or .mil. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. . International Journal of Orthopaedics. FOIA A total of nine studies were eligible for review. AJR Am J Roentgenol. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. 5. 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. Fig. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). Bookshelf proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. Therefore, indications for ACL resection must be carefully selected. Bergin et al. 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. Anterior knee pain is the more common complaint. Mucoid change or mucoid degeneration refers to the irreversible tissue degeneration due to the accumulation of mucin within the fibers of tendons, ligaments, and fibrocartilage. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). It has recently been postulated that mucoid degeneration of the ACL is related to the medial knee compartment joint space loss in patients with osteoarthritis or in the OA risk group 6. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR.