Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. 2007;15 (1): 73-86. Clin Orthop Surg. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. 2009. and transmitted securely. eCollection 2022 May-Jun. Disclaimer. Knee Surgery & Related Research What Is Mucoid Degeneration of the ACL? Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Physical Therapy. National Library of Medicine 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. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. sharing sensitive information, make sure youre on a federal The quality of methodology was excellent in one study, good in five studies, low in two studies and very low in one study (Tables 1 and 2). 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. 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. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Its function is to stabilize the knee while bending and rotating; the ACL also keeps the knee from shifting out of place or moving anteriorly (toward the front) with pivoting activities. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . mucoid degeneration acl symptoms. PMC 1999;81(2):304305. For non-comparative studies, this consists of eight questions. Preoperative magnetic resonance imaging (MRI), Fig. Two patients uderwent secondary ligamentoplasty. Bookshelf Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. 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. A long duration of non-specific knee pain in a patient should be evaluated with MRI. -, Fealy S, Kenter K, Dines JS, Warren RF. Mucoid degeneration of the anterior cruciate ligament: a case report. Knee Surgery, Sports Traumatology, Arthroscopy. What you feel (symptoms) You feel heaviness in knee joint. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. [17] do not mention whether any patients underwent biopsy (Table 3). . Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. International Journal of Orthopaedics. 2 ). Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. The author(s) read and approved the final manuscript. A total of 313 knees in 292 patients were included. Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Morice et al. Symptomatic ACL mucoid degeneration in middle-age athletes. All rights reserved. It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. This site needs JavaScript to work properly. Chudasama et al. A total of 313 knees in 292 patients were included in the nine studies. Unauthorized use of these marks is strictly prohibited. 287 (3): 912-921. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. AJR Am J Roentgenol. official website and that any information you provide is encrypted Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Instrumental treatment. The site is secure. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. An official website of the United States government. An official website of the United States government. ACL tears don't heal as such. 8600 Rockville Pike Patients will . PROSPERO. Seventeen females (67%) and eight males (33%) were included in the final analysis. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. These appearances must be differentiated from mucoid degeneration of the intact ACL. FOIA 2001;30(6):312315. Postoperative pain relief ranged from 53.8 to 95%. Epub 2011 Feb 18. This was lowest in the study of Cha et al. FOIA Disclaimer. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Unauthorized use of these marks is strictly prohibited. Would you like email updates of new search results? If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Conclusion: Please enable it to take advantage of the complete set of features! Each study was scored 02 on each question, with a global ideal score of 16. Magn Reson Imaging Clin N Am. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Individuals were included in the study if they had had complete MRIs of the affected knee at baseline and at 4-year follow-up, had thigh MRIs at baseline and had no additional surgery in the meantime. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. 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. Along with that, it also controls the internal rotation. There was strong association with chondral lesions and meniscal tears. Initially, partial weightbearing is allowed. 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). Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. Correspondence to 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. . Epub 2018 Apr 21. Generally, we know little about this condition. . Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Knee Surg Sports Traumatol Arthrosc. 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. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 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. MDACL is differentiated from synovial cysts of the anterior cruciate ligament (ACL) where, in MDACL, mucoid tissue intermingles within ACL fibres and is not contained within a cyst [3]. Bethesda, MD 20894, Web Policies Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Provided by the Springer Nature SharedIt content-sharing initiative. J Orthop. eCollection 2013. W B Saunders Co. (2005) ISBN:0721602703. Accessibility Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. No reconstruction was performed at the same time. Instrumental treatment. 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. (Table 3). (2018) Radiology. Mucoid degeneration of the ACL is a rare cause of knee pain.1-8) This lesion of the ACL was first reported by Kumar et al.3) in 1999. 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. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. AJR Am J Roentgenol. https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Epub 2010 May 8. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Privacy Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. Arch Orthop Trauma Surg. Methods: 1. Papadopoulou P. The celery stalk sign. and transmitted securely. Epub 2021 Nov 24. : A Meta-Analysis. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. Epub 2013 Aug 27. 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.