The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. Four studies reported only postoperative scores, which were comparable to those in other studies. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. 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. Mucoid degeneration of the anterior cruciate ligament. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). and Ventura et al. At the time the article was created Frank Gaillard had no recorded disclosures. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. in 1999 [ 1 ]. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. The site is secure. The https:// ensures that you are connecting to the 8600 Rockville Pike Mucoid degeneration of the anterior cruciate ligament. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Indian J Orthop. 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. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Google Scholar, Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D (2011) Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Orthop Traumatol Surg Res. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . AJR Am J Roentgenol. 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. Items are scored as 0 (not reported), 1 (reported but inadequate) or 2 (reported and adequate). Method. KoreaMed Synapse . Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. Reeducation. Knee Surg Sports Traumatol Arthrosc. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. eCollection 2021. 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. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. 2004;182 (5): 1283-7. Skeletal Radiology. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Disclaimer. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment An official website of the United States government. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. official website and that any information you provide is encrypted Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon non-traumatic cause of knee pain and motion restriction, typically seen in a middle-aged population. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. (Table 3). Mucinous material within the substance of ACL produces pain and limited motion in the knee. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Knee. Hide glossary Glossary. 2013;15(1). ACL MUCOID DEGENERATION RADIOLOGY MRI - Radedasia Anterior Cruciate Ligament, is an important structure of the knee joint. 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 . Epub 2011 Feb 18. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. Mucoid degeneration of the anterior cruciate ligament sharing sensitive information, make sure youre on a federal (PDF) Assessment of imaging, pathoanatomy and - Academia.edu Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. . HHS Vulnerability Disclosure, Help Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Score: 4.7/5 (45 votes) . Epub 2013 Aug 27. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Mucoid change | Radiology Reference Article | Radiopaedia.org All patients (100%, n=11) reported a good to very good surgery satisfaction. Knee Surg Sports Traumatol Arthrosc. 2023 BioMed Central Ltd unless otherwise stated. The site is secure. mucoid degeneration of acl - Best Orthopedic doctor in Jaipur Bethesda, MD 20894, Web Policies Anterior cruciate ligament mucoid degeneration: Selecting the best 2018 Sep;10(3):307-314. doi: 10.4055/cios.2018.10.3.307. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. 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. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. The total number of patients with symptomatic instability was 18 out of 288 (6%). Any discrepancy was resolved by the senior author. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. J Chin Med Assoc. Mucoid degeneration of anterior cruciate ligament (ACL) Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. An official website of the United States government. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Bookshelf Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. Before the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. You can read more if you want. 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. https://doi.org/10.1046/j.1445-2197.2003.02748.x, Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a systematic review. Clin Orthop Surg. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. The mean MINORS score was 9.5 out of 16 (412). Anterior Cruciate Ligament (ACL) MRI: Practice Essentials, Anatomy Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. Preoperative magnetic resonance imaging (MRI) scan. J Orthop. Intact fibers are best seen on T2WI. Postoperative pain relief was reported in seven studies. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. The pathogenesis remains controversial. National Library of Medicine 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. TS designed the project, literature search and wrote the manuscript. Bone and joint imaging. On clinical examination, the active range of motion showed a flexion deficit. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. government site. 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. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. 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. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Management of mucoid degeneration of the anterior cruciate ligament: a Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. official website and that any information you provide is encrypted The authors declare that they have no competing interests. This site needs JavaScript to work properly. Knee Surg Sports Traumatol Arthrosc. volume33, Articlenumber:26 (2021) A 48-year-old-male patient presented with knee pain and limitation of motion. Seventeen females (67%) and eight males (33%) were included in the final analysis. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. eCollection 2022 May-Jun. National Library of Medicine However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Two patients uderwent secondary ligamentoplasty. 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 . Knee Surgery & Related Research Chudasama et al. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. statement and Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. 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. J Chin Med Assoc. Introduction to Arthroscopic Debridement 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 mean age of patients ranged from 31 to 78years. California Privacy Statement, Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. PROSPERO. What is myxoid degeneration treatment? Level of evidence: National Library of Medicine Epub 2010 May 8. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. 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. . 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]. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. Check for errors and try again. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 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. However, the authors did not report whether there were any other patients with symptomatic instability. 6. (A) Bulging of, Fig. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. J Bone Joint Surg Br. An official website of the United States government. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. 1. bling. and transmitted securely. Knee Surg Sports Traumatol Arthrosc. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Anterior cruciate ligament mucoid degeneration: selecting the best Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). government site. In most cases Physiopedia articles are a secondary source and so should not be used as references. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Epub 2011 Feb 18. Indian J Orthop 48(2):197202. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). National Library of Medicine Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Accessed 1 Mar 2021. Results: Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. (2018) Radiology. 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. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. 1999;81(2):304305. It is a chronic degenerative change of a bulky ACL that may lead to notch impingement syndrome in the absence of instability symptoms and significant trauma history [ 1, 2, 3, 4 ]. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. 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. Pandey, Vivek et al. https://www.physio-pedia.com/index.php?title=Anterior_Cruciate_Ligament_(ACL)_Mucoid_Degeneration&oldid=253974, Difficulty in climbing stairs, cross-leg sitting, squatting, Primary condition- Osteoarthritis, degenerative menisci, meniscal tear, Impingement of the soft tissue in the vicinity.
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