2013;15(1). 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]. 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. Noninfiltrating synovial cysts of the ACL were excluded. This makes it difficult to relate the improvement of symptoms to ACL debridement. Online ahead of print. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Arthroscopy. Knee Surg & Relat Res 33, 26 (2021). 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. . I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Unauthorized use of these marks is strictly prohibited. . To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Accessibility The mean MINORS score was 9.5 (range 412). PubMedGoogle Scholar. Truncation means that the . Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. The purpose of this study was to investigate the outcome of management of MDACL by performing a systematic review of methods of treatment that have been reported. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Bethesda, MD 20894, Web Policies Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. 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 anterior cruciate ligament (ACL ). 2012;4 (2): 167-70. Fourteen knees (48%) had limited flexion, on average 97 degrees. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. Knee Surgery & Related Research AJR Am J Roentgenol. 8600 Rockville Pike Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Therefore, indications for ACL resection must be carefully selected. MeSH Anterior cruciate ligament mucoid degeneration. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. reported the largest percentage of patients (27.5%) with a positive pivot test. Bergin et al. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Epub 2008 Apr 18. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). CAS Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. sharing sensitive information, make sure youre on a federal and transmitted securely. Unable to load your collection due to an error, Unable to load your delegates due to an error. The clinical presentation is one of posterior pain with limited flexion. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. 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. What is Anterior Cruciate Ligament Mucoid Degeneration? eCollection 2013. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Physiotherapy. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. ACL tears don't heal as such. 2011. When refering to evidence in academic writing, you should always try to reference the primary (original) source. The total number of patients with symptomatic instability was 18 out of 288 (6%). Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. Bethesda, MD 20894, Web Policies Bookshelf Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. None of the studies was a randomised controlled trial and none had a control group. 2011 Aug 1;19(8):1326-33. Federal government websites often end in .gov or .mil. J Sports Med Phys Fitness 48(4):483487, PubMed J Knee Surg. Arthroscopic debridement may help relieve the anterior knee pain. Morice et al. An official website of the United States government. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. Score: 4.7/5 (45 votes) . Conclusion: Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. National Library of Medicine 8600 Rockville Pike in 1999 [ 1 ]. 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. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Open Grey database was searched for grey literature using the same keywords. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. In the Lintz study, total resection of the ACL was performed in 17 out of 29 knees, while in the Ventura study total resection was performed in 17 out of 25 patients. Level of Evidence: Level IV. Accessibility 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 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.). Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Chudasama et al. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. The success of treatment for MDACL and the subsequent risk of instability is not known. Mucoid degeneration of the anterior cruciate ligament. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. On clinical examination, the active range of motion showed a flexion deficit. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. An official website of the United States government. 2. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. Mucoid degeneration of ACL is a disease affecting ACL in which mucoid like substance (glycosaminoglycans) gets interspersed within the substance of ACL and as a result ACL gets thickened. Any discrepancy was resolved by the senior author. Postoperative clinical laxity was common, however, symptomatic instability was not. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . Symptoms included limited range of motion (ROM) and posterior knee pain. Arthroscopy 24(6):642649. Check for errors and try again. Glossary of terms for musculoskeletal radiology. Bergin D, Morrison WB, Carrino JA et-al. National Library of Medicine Careers. This appearance can mimic acute or chronic interstitial partial tears of the ligament. (Table 3). 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. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. Knee Surg Sports Traumatol Arthrosc. Arch Orthop Trauma Surg. Hypothesis: 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 diagnostic criteria [7] are (1) continuous ACL fibres, (2) increased ACL volume, (3) yellowish-coloured material expressed on palpation and (4) loss of ACL synovial lining. J Chin Med Assoc. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. -, Hodler J, Haghighi P, Trudell D, Resnick D. The cruciate ligaments of the knee: Correlation between MR appearance and gross and histologic findings in cadaveric specimens. GG and AM interpreted the results and reviewed the manuscript. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. IV (retrospective cohort study). It results in postoperative laxity, but rarely in frank instability. Cho SD, Youm YS, Lee CC et-al. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. This site needs JavaScript to work properly. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-3615, Case 11: with Hoffa fat pad ganglion cyst, Case 12: tibial nerve schwannoma and ACL mucoid degeneration, Case 1: Complete ACL tear and meniscal tears, Case 2: Anomalous insertion of the medial meniscus, View Frank Gaillard's current disclosures, see full revision history and disclosures, anterior cruciate ligament ganglion cysts, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Mucoid degeneration of the anterior cruciate ligament, congenital or acquired synovial tissue entrapment between ACL fibers. statement and There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Anterior Cruciate Ligament, is an important structure of the knee joint. Individuals with mucoid degeneration of the ACL were excluded. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid
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