Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. in 1999 [1]. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Knee Surg Sports Traumatol Arthrosc. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. Ligaments hold our bones together and allow us to bend, twist, pivot and rapidly accelerate and decelerate and yet maintain the stability of our joints. A total of nine studies were eligible for review. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. The mean MINORS score was 9.5 (range 412). 2011. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Epub 2018 Jun 13. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. All rights reserved. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. At the time the article was last revised Dai Roberts had no recorded disclosures. reported the largest percentage of patients (27.5%) with a positive pivot test. 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]. 1999;81(2):304305. Disclaimer. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Online ahead of print. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. However, the authors did not report whether there were any other patients with symptomatic instability. 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. 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. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Privacy Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Careers. Any discrepancy was resolved by the senior author. Bookshelf Anterior Cruciate Ligament, is an important structure of the knee joint. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. 2. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid CAS Multiple theories have been put forth that explains the pathological disorganization in the collagen fibers of the Anterior Cruciate Ligament, such as synovial, traumatic, and degenerative, "Synovial theory- states that there is accumulation of synovial fluid inside the substance of ACL in a herniated pouch of synovium. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Mucoid degeneration of the anterior cruciate ligament. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. 8600 Rockville Pike government site. Accessibility The site is secure. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. 2009. (A) Bulging of the hypertrophied anterior cruciate ligament. An official website of the United States government. The mean age at the time of surgery was 57 years (range, 31 to 78 years). 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. Roberts CC, Towers JD, Spangehl MJ et-al. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Anterior knee pain is the more common complaint. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. MeSH Symptomatic ACL mucoid degeneration in middle-age athletes. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Clipboard, Search History, and several other advanced features are temporarily unavailable. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Symptoms included limited range of motion (ROM) and posterior knee pain. Mucoid degeneration of both ACL and PCL. Instrumental treatment. Check for errors and try again. All nine studies were case series; six were retrospective and three were prospective studies. 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. Mucoid degeneration of the anterior cruciate ligament. Part of Epub 2018 Apr 21. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. 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. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. This site needs JavaScript to work properly. eCollection 2022 May-Jun. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Copyright 2010 Elsevier Masson SAS. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. In six of the nine studies [6, 14, 16,17,18], arthroscopic debridement of the ACL was associated with simultaneous partial meniscectomy; this ranged from 13% in the study of Morice et al. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. and transmitted securely. Knee Surg Sports Traumatol Arthrosc. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Conclusions. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. reported on the co-existence of mucoid degeneration and ganglia of the ACL. 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. J Bone Joint Surg Br. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Symptomatic ACL mucoid degeneration in middle-age athletes. AJR Am J Roentgenol. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Mucinous material within the substance of ACL produces pain and limited motion in the knee. [17] do not mention whether any patients underwent biopsy (Table 3). Epub 2008 Dec 17. W B Saunders Co. (2005) ISBN:0721602703. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Indian J Orthop 46(5):561565. Pandey, Vivek et al. . Radiology. J Orthop. https://doi.org/10.1016/j.jclinepi.2009.06.005. 5. J Chin Med Assoc. Khanna et al. Anterior cruciate ligament mucoid degeneration. 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. Arch Orthop Trauma Surg. mucoid degeneration of acl mri. Epub 2018 Aug 22. It is a chronic degenerative change of a bulky ACL that may lead to notch . Meniscectomy was undertaken in 11 cases (41%). Sagittal T2-weighted MRI view showing intact anterior, Fig. FOIA However, symptomatic instability was not common. The https:// ensures that you are connecting to the 2011. JBR-BTR. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. 4. Other theories include Degenerative theory- MD could occur due to ageing.[3]. Each study was scored 02 on each question, with a global ideal score of 16. International Journal of Orthopaedics. This makes it difficult to relate the improvement of symptoms to ACL debridement. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Second, methodological quality assessment showed that three studies had low methodological quality. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. In most cases Physiopedia articles are a secondary source and so should not be used as references. (B) Partial resection, MeSH Keywords: Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? Clipboard, Search History, and several other advanced features are temporarily unavailable. Unauthorized use of these marks is strictly prohibited. and transmitted securely. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Introduction: Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. 2006;69(9):44952. Anatomopathology samples were collected in 18 cases. . Arthroscopic findings. Epub 2011 Feb 18. 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 . Bergin et al. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Arthroscopy. Bone and joint imaging. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. eCollection 2013. Careers. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Please enable it to take advantage of the complete set of features! Conclusions: Mucoid degeneration of the ACL is a clinical condition afflicting active middle-aged people without a single significant traumatic episode with a specific MRI picture. The total number of patients with symptomatic instability was 18 out of 288 (6%). There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Clinical Outcomes, Return to Sports, and Patient Satisfaction After Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients in an Asian Population-A 2-Year Follow-up Study. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT 2,375 views Sep 15, 2019 23 Dislike Dr. Prateek Joshi- Ortho 1.02K subscribers Notice Age-restricted video (based on Community Guidelines).