Fig. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. 2004;182 (5): 1283-7. J Bone Joint Surg Ser B 81(2):304305. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Second, methodological quality assessment showed that three studies had low methodological quality. Diffuse Intrasubstance Signal Abnormalities Ofthe Posterior Cruciate They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Before 2023 BioMed Central Ltd unless otherwise stated. Reeducation. 1992;159(2):35760. The minimum follow-up was 3 years. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. 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. Imaging: Plain radiographs Mucoid degeneration of ACL | Mayo Clinic Connect The appearance can mimic acute or chronic interstitial partial tears of the ACL. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. What causes mucoid degeneration of ACL? 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). 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. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. National Library of Medicine official website and that any information you provide is encrypted Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Postoperative pain relief ranged from 53.8 to 95%. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. bling. However, symptomatic instability was not common. Epub 2018 Aug 22. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. -. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. 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. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. Knee Surg Sports Traumatol Arthrosc. Please enable it to take advantage of the complete set of features! Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. Epub 2013 Aug 27. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. For non-comparative studies, this consists of eight questions. Conclusion: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. PubMedGoogle Scholar. (10%) and highest in the study of Ventura et al. Anterior cruciate ligament mucoid degeneration - Radiopaedia Disclaimer. However, MDACL is asymptomatic in most patients. Arch Orthop Trauma Surg. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. The clinical presentation is one of posterior pain with limited flexion. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Bookshelf Please enable it to take advantage of the complete set of features! 42 Mucoid degeneration of the anterior cruciate ligament with erosion of the lateral femoral condyle P. Melloni, R. Valls, M. Yuguero, A. Saez Medicine reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. This systematic review has some limitations. Terms and Conditions, 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. 2. reported on the co-existence of mucoid degeneration and ganglia of the ACL. MM and A performed the literature search, and data analysis. The .gov means its official. Clin Orthop Surg. The appearance can mimic acute or chronic interstitial partial tears of the ACL. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). We herein describe a case of PCL mucoid degeneration presented with secondary ACL . See this image and copyright information in PMC. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. 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. National Library of Medicine What causes myxoid degeneration? - Shabupc.com Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. Keywords used for the Search were mucoid degeneration, anterior cruciate ligament and ACL. AJR Am J Roentgenol. Thirteen patients were treated with complete ACL resection for symptomatic MD of the ACL from 2006-2016. 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. A total of 313 knees in 292 patients were included in the nine studies. Papadopoulou P. The celery stalk sign. NCI CPTC Antibody Characterization Program. Epub 2010 May 8. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. Knee Surg & Relat Res 33, 26 (2021). The primary intervention was arthroscopic ACL debridement in eight studies; this was combined with notchplasty in cases of impingement with the lateral wall of the notch in five studies [6, 14, 16,17,18] (Table 3). The anterior cruciate ligament (ACL) is an important ligament in the knee. The site is secure. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Epub 2018 Jun 13. 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. MeSH Average postoperative International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were 71.2 (42.5 to 92.0) and 78.2 (26.4 to 99). mucoid degeneration of acl mri. in 1999 [1]. FOIA 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. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. It can cause pain and to a meniscal tear. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. (PDF) Assessment of imaging, pathoanatomy and - Academia.edu Physiotherapy. Therefore, indications for ACL resection must be carefully selected. Partial Anterior Cruciate Ligament - ACL - Tears - Howard J. Luks, MD This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. . 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. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Orthop Traumatol Surg Res 96(4):400406, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Methods: The minimum follow-up was 3 years. MeSH Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. 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. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient.
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