Anterior knee pain is the more common complaint. Unable to load your collection due to an error, Unable to load your delegates due to an error. Unauthorized use of these marks is strictly prohibited. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 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. Bookshelf Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. . -, Fealy S, Kenter K, Dines JS, Warren RF. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . Careers. 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). 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. report that one patient had ACL reconstruction simultaneously after the ACL debridement. Read More Created for people with ongoing healthcare needs but benefits everyone. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . On clinical examination, the active range of motion showed a flexion deficit. . Noninfiltrating synovial cysts of the ACL were excluded. However, MDACL is asymptomatic in most patients. Would you like email updates of new search results? A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. 2009. HHS Vulnerability Disclosure, Help All rights reserved. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. This is a rare pathological condition, in which, there is increased signal from within the ligament. Please enable it to take advantage of the complete set of features! Roberts CC, Towers JD, Spangehl MJ et-al. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Furthermore, this raises the question as to whether the symptoms (pain and diminished range of movement) were solely due to MDACL and not secondary to other associated pathological conditions. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Before Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. Conclusion: 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. Privacy Pan African Medical Journal. 1). Level of Evidence: Level IV. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Arthroscopic findings. Orthop Traumatol Surg Res. The success of treatment for MDACL and the subsequent risk of instability is not known. Physical therapy typically begins 7-10 days after the procedure. https://doi.org/10.1016/j.jclinepi.2009.06.005. 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine Would you like email updates of new search results? Knee Surgery, Sports Traumatology, Arthroscopy. ACL debridement was partial in all studies except for those by Lintz et al. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. JBR-BTR. and transmitted securely. Knee Surg Sports Traumatol Arthrosc. Arthroscopy. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. What Is Mucoid Degeneration of the ACL? Symptomatic ACL mucoid degeneration in middle-age athletes. The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment. Signal intensity of the anteromedial bundle (AMB) or posterolateral bundle (PLB) graft standardized to the intensity of the PCL was defined as signal intensity ratio (SIR). Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. 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. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. There was a high rate of association between degenerative lesions and MDACL, ranging from 39 to 96%. Unable to process the form. Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. . Anterior cruciate ligament mucoid degeneration. The authors declare that they have no competing interests. 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. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. Glossary of terms for musculoskeletal radiology. proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. This ranged from 90 to 95% in all studies, except in the report by Kim et al., where only 53.8% of patients (57/106) had complete pain relief after surgery. Arthroscopy 20(2):141146. The https:// ensures that you are connecting to the Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. GG and AM interpreted the results and reviewed the manuscript. 2004;182(5):12837. [Diagnosis and treatment of anterior cruciate ligament cysts]. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. J Orthop. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. Disclaimer. Sep 2017 - Feb 20186 months. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. These appearances must be differentiated from mucoid degeneration of the intact ACL. Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased signal intensity and a celery stalk appearance of intact fibers. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. eCollection 2022 May-Jun. 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. The mean age of patients ranged from 31 to 78years. 3. All patients (100%, n=11) reported a good to very good surgery satisfaction. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). PMC Arch Orthop Trauma Surg. Mucoid degeneration of the anterior cruciate ligament. 1992;159(2):35760. 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. TS designed the project, literature search and wrote the manuscript. The author(s) read and approved the final manuscript. Sagittal T2-weighted MRI view showing intact anterior, Fig. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. https://doi.org/10.1016/j.jajs.2015.12.001, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J (2018) Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. 2004;182(5):12831287. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. Unauthorized use of these marks is strictly prohibited. The anterior cruciate ligament (ACL) is an important ligament in the knee. Papadopoulou P. The celery stalk sign. Disclaimer. Before Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. It has recently been postulated that mucoid degeneration of the ACL is related to the medial knee compartment joint space loss in patients with osteoarthritis or in the OA risk group 6. Mucoid degeneration of the anterior cruciate ligament. Arthroscopy. sharing sensitive information, make sure youre on a federal Cookies policy. Bilateral Symptomatic Mucoid Degeneration of the Anterior Cruciate Ligament with Anterior Knee Pain but No Limited Knee Flexion. Correspondence to 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. 2011. in 1999 [ 1 ]. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). Would you like email updates of new search results? Questions just answered: mucoid degeneration of acl physiotherapy. The retrospective study by Kim et al. to 44% in the study of Cha et al. ADVERTISEMENT: Supporters see fewer/no ads. Orthop Traumatol Surg Res. government site. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. MeSH https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. Please enable it to take advantage of the complete set of features! There was strong association with chondral lesions and meniscal tears. and transmitted securely. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. There was an improvement in postoperative range of motion and outcome scores (Lysholm and International Knee Documentation Committee scores and the Knee Injury and Osteoarthritis Outcome Score). There is no consensus on treatment and evidence is scarce. 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. Fig. 2011. Seventeen females (67%) and eight males (33%) were included in the final analysis. Skeletal Radiology. The cause is not really known, but patients usually do not complain of instability. Provided by the Springer Nature SharedIt content-sharing initiative. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Am J Roentgenol 182(5):12831287. Accessibility Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. : A Meta-Analysis. Physiotherapy. (A) Bulging of the hypertrophied anterior cruciate ligament. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. Mucinous material within the substance of ACL produces pain and limited motion in the knee. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. 8600 Rockville Pike 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Bergin et al. Springer Nature. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Physical Therapy. Knee Surg Sports Traumatol Arthrosc. 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. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2013 Aug 27. Federal government websites often end in .gov or .mil. 2011 Mar;25(3):262-5. Bookshelf 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. (2018) Radiology. Knee Surg Sports Traumatol Arthrosc. Symptoms included limited range of motion (ROM) and posterior knee pain. Symptomatic instability was highest in the study of Lintz et al. The https:// ensures that you are connecting to the Mucoid degeneration of the anterior cruciate ligament. Introduction: Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. By using this website, you agree to our 2011. Epub 2011 Feb 18. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH Introduction: Unauthorized use of these marks is strictly prohibited. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). what causes mucoid degeneration of acl. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. eCollection 2022 May-Jun. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Clin Orthop Surg. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. 2007;245 (3): 916-7. 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. Twelve partial and 17 total resections were performed. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. CAS Bergin D, Morrison WB, Carrino JA et-al.
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mucoid degeneration of acl physiotherapy