Learn how we can help 704 views Reviewed >2 years ago Thank Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. Careers. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? A 48-year-old-male patient presented with knee pain and limitation of motion. 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). Am J Roentgenol 182(5):12831287. Despite the low rate of complications in all studies, there was a high incidence of postoperative knee laxity, demonstrated by a positive Lachman test, in most studies. The .gov means its official. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. 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.). However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Tamer Sweed. Would you like email updates of new search results? 2011 Aug 1;19(8):1326-33. 2001;30(6):312315. and Ventura et al. 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. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. This site needs JavaScript to work properly. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). The minimum follow-up was 3 years. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Average patient age was 49 (22 to 68) years. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. Epub 2011 Feb 18. statement and government site. -. Clipboard, Search History, and several other advanced features are temporarily unavailable. The site is secure. PMC Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. mucoid degeneration of acl mri. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 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. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. 1). Arthroscopy 20(2):141146. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Methods: Mucoid degeneration of the anterior cruciate ligament. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee 2012;4 (2): 167-70. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 2004;182(5):12831287. Cookies policy. MM and A performed the literature search, and data analysis. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Meniscectomy was undertaken in 11 cases (41%). This was lowest in the study of Cha et al. Epub 2018 Jun 13. Orthop Traumatol Surg Res. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Would you like email updates of new search results? PubMed and transmitted securely. No treatment is usually required. Dietary management and various treatments Scanning and diagnostic . to 44% in the study of Cha et al. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. None of the studies was a randomised controlled trial and none had a control group. A long duration of non-specific knee pain in a patient should be evaluated with MRI. 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 . Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. The extracted data were assessed for meta-analysis. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. 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). At the time the article was created Frank Gaillard had no recorded disclosures. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. Please enable it to take advantage of the complete set of features! Knee Surg Sports Traumatol Arthrosc. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Instrumental treatment. [18] did not comment on an association between MDACL and chondral or meniscal lesions: after the exclusion of that report, the total number of patients with associated chondral lesions was 226 out of 275 patients (82%) and 190 patients had meniscal lesions (69%). Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. Accessibility Epub 2018 Jan 2. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. AJR Am J Roentgenol. Introduction: Epub 2021 Nov 24. 287 (3): 912-921. in this condition your acl (anterior cruciate ligament) filled with jelly like material and it thickened so space in intercondylar resion of knee joint is reduced. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Would you like email updates of new search results? have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. Anatomopathology samples were collected in 18 cases. Arthroscopy. Indian J Orthop 46(5):561565. The https:// ensures that you are connecting to the Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 2008;24(6):642649. Any discrepancy was resolved by the senior author. did not report on this. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. Bone and joint imaging. Terms and Conditions, Knee Surg Sports Traumatol Arthrosc. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. in 1999 [ 1 ]. See this image and copyright information in PMC. 2013;15(1). 5. (61years), which was the largest study and represented more than one third of the total patients included in this review. (B) Partial resection, MeSH Knee. 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. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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. Online ahead of print. Arch Orthop Trauma Surg. Symptomatic ACL mucoid degeneration in middle-age athletes. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). 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. Skeletal Radiol. (100%). Disclaimer. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Fig. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. . For non-comparative studies, this consists of eight questions. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Intact fibers are best seen on T2WI. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. sharing sensitive information, make sure youre on a federal Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. It results in postoperative laxity, but rarely in frank instability. In most cases Physiopedia articles are a secondary source and so should not be used as references. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. The .gov means its official. -Evaluated and planned treatment protocol in accordance with physician. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. 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. HHS Vulnerability Disclosure, Help An 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. Khanna et al. 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. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. 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. 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. https://doi.org/10.2214/ajr.182.5.1821283, Article 2. 1. Rehabilitation, orthophony, crenotherapy. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Results: A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Four studies reported only postoperative scores, which were comparable to those in other studies. Kwee RM, Hafezi-Nejad N, Roemer FW, Zikria BA, Hunter DJ, Guermazi A, Demehri S. Association of Mucoid Degeneration of the Anterior Cruciate Ligament at MR Imaging with Medial Tibiofemoral Osteoarthritis Progression at Radiography: Data from the Osteoarthritis Initiative. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Conclusions: 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. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). 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. This is a rare pathological condition, in which, there is increased signal from within the ligament. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Other theories include Degenerative theory- MD could occur due to ageing.[3]. Mucoid degeneration of the anterior cruciate ligament. reported on the co-existence of mucoid degeneration and ganglia of the ACL. Pandey, Vivek et al. Bethesda, MD 20894, Web Policies