HHS Vulnerability Disclosure, Help -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. PMC Symptomatic ACL mucoid degeneration in middle-age athletes. Instrumental treatment. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Indian J Orthop. Therefore, indications for ACL resection must be carefully selected. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Background: 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). 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. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Kwee RM, Hafezi-Nejad N, Roemer FW, Zikria BA, Hunter DJ, Guermazi A, Demehri S. Association of Mucoid Degeneration of the Anterior Cruciate Ligament at MR Imaging with Medial Tibiofemoral Osteoarthritis Progression at Radiography: Data from the Osteoarthritis Initiative. As there was no control group in any of the studies and the natural history of MDACL is not known, the postoperative improvement may have been attributed to the placebo effect, simultaneous arthroscopic procedures or the postoperative rehabilitation, or may be due to the pain having resolved without treatment at all. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. 2011 Aug 1;19(8):1326-33. 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. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. This may support the theory that it is a degenerative process. At the time the article was last revised Dai Roberts had no recorded disclosures. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Epub 2008 Dec 17. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. and transmitted securely. This is a rare pathological condition, in which, there is increased signal from within the ligament. 2004;182 (5): 1283-7. J Arthrosc Joint Surg 3(1):2833. Epub 2011 Feb 18. Unable to load your collection due to an error, Unable to load your delegates due to an error. FOIA Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. The aetiology of MDACL is not clearly understood. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Results: It often presents with progressive knee pain, restriction in range of motion without a significant history of trauma, and without knee instability. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. 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. . Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. Epub 2010 May 8. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. Results: International Journal of Orthopaedics. and Ventura et al. Would you like email updates of new search results? Level of evidence: Seventeen females (67%) and eight males (33%) were included in the final analysis. Epub 2010 May 8. 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. Ligaments and tendons are accumulated by mucoid change might display a thickened and/or hypertrophied appearance, with an increase in signal intensity. Accessibility What causes mucoid degeneration of ACL? Anatomopathology samples were collected in 18 cases. Orthopaedics & Traumatology: Surgery & Research. https://doi.org/10.1016/j.jclinepi.2009.06.005. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). Arthroscopy 20(2):141146. The origin of MDACL may be degenerative or traumatic. 2001;30(6):312315. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. 5. . Pain was posterior in 23 knees (80%). ACL tears don't heal as such. ADVERTISEMENT: Supporters see fewer/no ads. The https:// ensures that you are connecting to the The patient presented with extension block of the knee. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . Physiotherapy. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Clipboard, Search History, and several other advanced features are temporarily unavailable. Fourteen knees (48%) had limited flexion, on average 97 degrees. Mucoid degeneration of the anterior cruciate ligament. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. 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. Sep 2017 - Feb 20186 months. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. 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]. 2013;15(1). 2004;182(5):12837. The appearance can mimic acute or chronic interstitial partial tears of the ACL. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. There is no consensus on treatment and evidence is scarce. A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. Please enable it to take advantage of the complete set of features! and transmitted securely. 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. Would you like email updates of new search results? FOIA The clinical presentation is one of posterior pain with limited flexion. Epub 2013 Aug 27. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Mucoid degeneration of both ACL and PCL. https://doi.org/10.2214/ajr.182.5.1821283, Article The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. Learn how we can help 704 views Reviewed >2 years ago Thank Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity that has been found in patients with pain and limited range of motion of the knee in association with a bulky ACL shown on magnetic resonance imaging (MRI). Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). 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. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. The .gov means its official. Score: 4.7/5 (45 votes) . Knee Surg & Relat Res 33, 26 (2021). 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 of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Rehabilitation, orthophony, crenotherapy. Bone and joint imaging. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament.
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