MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. Hide glossary Glossary. The .gov means its official. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. The origin of MDACL may be degenerative or traumatic. 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. By using this website, you agree to our 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. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Arthroscopy. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. An official website of the United States government. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Categories were determined in accordance with the study of Ekhtiari et al. Epub 2018 Aug 22. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. 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. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. Keywords: 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 . Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. Please enable it to take advantage of the complete set of features! Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Conclusions. Careers. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. The need for simultaneous or delayed ACL reconstruction should be discussed with patients in case total resection of the ACL is to be performed, particularly in young active patients. Chudasama et al. National Center for Biotechnology Information Physiotherapy. Please enable it to take advantage of the complete set of features! Anatomopathology samples were collected in 18 cases. Accessibility Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Arthroscopy. Online ahead of print. This is a rare pathological condition, in which, there is increased signal from within the ligament. Knee Surg Sports Traumatol Arthrosc. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Sep 2017 - Feb 20186 months. Learn how we can help 704 views Reviewed >2 years ago Thank Accessed 1 Mar 2021. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH Truncation means that the . It may lead to knee pain. The patient presented with extension block of the knee. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. 2010 Jun 1;96(4):400-6. National Library of Medicine just over two decades ago [], the interest in this condition has quickly gathered pace in the orthopaedic community.Little is known about this condition that affects 1.8-5.3% of the population as per magnetic resonance imaging (MRI) diagnosis [2, 3]. Anterior cruciate ligament mucoid degeneration - Radiopaedia Epub 2011 Feb 18. 1 Its prevalence in magnetic resonance imaging (MRI) is 1.8-5.3%, but not all lesions are symptomatic.2, 3 It is characterized by infiltration of mucoid-like substance (glycosaminoglycans) interspersed within the Arthroscopic findings. Mucoid degeneration of A C L is more common and literature has also reported many cases, but for PCL only few cases have been reported in English literature. Conclusions 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 . Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Arthroscopy. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Mucoid degeneration of the anterior cruciate ligament: Partial Arch Orthop Trauma Surg. Learn.Physio on LinkedIn: Quadriceps and hamstring weakness are common There was a high rate of association between degenerative lesions and MDACL, ranging from 39 to 96%. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. This systematic review has some limitations. Copyright 2010 Elsevier Masson SAS. 2023 BioMed Central Ltd unless otherwise stated. 2001;17(9):E37. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. All nine studies were case series; six were retrospective and three were prospective studies. Careers. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Khanna et al. Mucoid degeneration of both ACL and PCL - PubMed Bone and joint imaging. Before PDF Mucoid degenerated anterior cruciate ligament managed by arthroscopic We herein describe a case of PCL mucoid degeneration presented with secondary ACL . https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. 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. However, symptomatic instability was not common. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. [17] do not mention whether any patients underwent biopsy (Table 3). mucoid degeneration acl symptoms. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). Chudasama CH, Chudasama VC, Prabhakar MM. reported on the co-existence of mucoid degeneration and ganglia of the ACL. did not report on this. Correspondence to Rehabilitation, speech therapy, crenotherapy. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. Second, methodological quality assessment showed that three studies had low methodological quality. The pathogenesis remains controversial. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a 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. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. https://doi.org/10.4103/0019-5413.128765, Article Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. 2. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Mucoid degeneration of the anterior cruciate ligament. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). : A Meta-Analysis. There is no consensus on treatment and evidence is scarce. We report a case of a patient with mucoid degeneration of the ACL, presenting with posterior knee pain and no history of a major knee trauma. HHS Vulnerability Disclosure, Help J Arthrosc Joint Surg 3(1):2833. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Cookies policy. 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. Am J Roentgenol 182(5):12831287. official website and that any information you provide is encrypted Unable to load your collection due to an error, Unable to load your delegates due to an error. Along with that, it also controls the internal rotation. https://doi.org/10.1016/j.arthro.2008.02.004, Morice A, Coupry A, Lintz F, Robert H (2013) Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Postoperative clinical laxity was common, however, symptomatic instability was not. This makes it difficult to relate the improvement of symptoms to ACL debridement. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. 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. Unauthorized use of these marks is strictly prohibited. Orthopaedics & Traumatology: Surgery & Research. Indian J Orthop 48(2):197202. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Clipboard, Search History, and several other advanced features are temporarily unavailable. Knee Surg Sports Traumatol Arthrosc. Besides, the patient may also have trouble in moving. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). I have persistent pain in the back of that knee that is exacerbated by walking and bending it. 2 ). IV (retrospective cohort study). 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. The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. Knee Surg Sports Traumatol Arthrosc. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. 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. and transmitted securely. This appearance can mimic acute or chronic interstitial partial tears of the ligament. and transmitted securely. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. 2004;182(5):12837. PMC Orthopedics; anterior cruciate ligament; arthoscopy. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Bethesda, MD 20894, Web Policies The mean age at the time of surgery was 57 years (range, 31 to 78 years). Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . What causes myxoid degeneration? - Shabupc.com 2007;15 (1): 73-86. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. bling. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. 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. The site is secure. It results in postoperative laxity, but rarely in frank instability. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. FOIA The https:// ensures that you are connecting to the Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. in 1999 [1]. All nine studies assessed the outcome of arthroscopic debridement of MDACL.
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