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. 3 Do-Dai DD, Youngberg RA, Lanchbury FD, et al: Intraligamentous ganglion cysts of the anterior cruciate ligament: MR findings with clinical and arthroscopic correlations. Grade 1A laxity on Lachmans test (less than 5mm translation with a firm end-point) was noted in 27 knees (11.95%) intra-operatively in group B or those who underwent debulking (nb=226), whereas a firm endpoint with no translation was noted in all of the remaining 199 knees (88.05%). Your 3-year nephew sta News comes out day after day about sexual harassment. During the physical exam, your doctor will check your knee for swelling and tenderness comparing your injured knee to your uninjured knee. what causes mucoid degeneration of acl. . Reactive marrow edema (arrowheads) surrounds the intraosseous ganglia. A single copy of these materials may be reprinted for noncommercial personal use only. Furthermore, the ancillary MR findings of an ACL tear, such as bone bruises and the MR anterior drawer sign, are absent. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. Ellman MB, et al. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. My MRI done in June states that I have very severe mucoid degeneration/partial thickness tearing of the ACL with the tibial spine tractional marrow edema. I know what the words mean. Physiotherapy. The authors acknowledge some limitations to this study. Injury prevention. Anyone else have this and how was it treated if at all? While both the groups showed improvements in the functional scores post-surgery, which could be attributed to the UKA primarily, the finding that patients in whom debulking was done had better mean IKDC and mean KSS at 2years follow-up confirmed the study hypothesis that debulking improves the long-term outcome in patients with MD-ACL undergoing UKA. Which Teeth Are Normally Considered Anodontia. 3 Do-Dai DD, Youngberg RA, Lanchbury FD, et al: Intraligamentous ganglion cysts of the anterior cruciate ligament: MR findings with clinical and arthroscopic correlations. Although a few studies such as the one by Lee etal. Informed written consent was obtained from all individual participants included in the study. Springer Nature. . On table, the extent of impingement caused by the mucoid degeneration was gauged using an arthroscopy hook. 21 yrs old Male asked about Mucoid degeneration of ACL, 2 doctors answered this and 92 people found it useful. 6 Antonacci VP, Foster T, Fenlon H, Harper K, Eustace S: Technical report: CT-guided aspiration of anterior cruciate ligament ganglion cysts. For such patients, decompression of the ganglion at arthroscopy or via CT guidance is indicated and provides prompt relief.3,5,6. This content does not have an English version. Various techniques have been proposed for the debulking of MD-ACL including arthroscopic debridement using shaver or radiofrequency ablation, with or without notchplasty, that have shown to give good clinical results [8, 19]. Mucoid degeneration of ACl is a rare pathological process involving knee joint. It is postulated that intraosseous extension may be a finding more often associated with pain (8a). Imagination. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Sterile saline (salt) solution is pumped into the knee through one incision to expand it and to wash blood from the area. Correspondence to Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament Clinics in Orthopedic Surgery Vol. MRI has been established as the gold standard imaging modality for the diagnosis of MD-ACL based on the criteria laid out by Bergin etal. Extraligamentous extension into the joint and intercondylar notch produces a higher incidence of mechanical symptoms (7a). https://doi.org/10.2214/ajr.182.5.18212835, Article It can trap and damage the menisci in the knee and can also lead to early osteoarthritis. Conclusion: PRP can be used to improve the healing and strength ofa weakened ACL after partial debridement, but further research is needed to demonstrate its efficacy. Besides, the patient may also have trouble in moving. 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 cruciate ligament, improving patient satisfaction and function without causing clinical instability in daily activities. Correlation with operation methods in 200 knees. statement and We believe that meniscal mucoid degeneration with tear is not uncommon. These are found inside your knee joint. 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 . Provided by the Springer Nature SharedIt content-sharing initiative. https://link.springer.com/10.1007/s00590-021-03198-4. With an increasing trend of UKA being performed worldwide, the role of addressing concomitant MD-ACL is vital in improving the overall outcome of the patient without causing any instability or implant failure, as shown in this study. 3). It included all patients who were diagnosed with mucoid degeneration of ACL and underwent mobile-bearing Oxford partial knee arthroplasty between January 2017 and February 2020, by consecutive sampling method. . Little is known about this condition that affects 1.85.3% of the population as per magnetic resonance imaging (MRI) diagnosis [2, 3]. 373) A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion and pericruciate synovitis . Mucoid degeneration of the anterior cruciate ligament (ACL) has been shown to cause restricted terminal range of motion and rest pain. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. My knee pains while I sit on the floor or its difficult for me to stand or walk for a long time or I find its difficult to descend the stairs or my knee gets tired easily these days are the usual complaints. The rest of the surgery remained the same and all patients underwent mobile-bearing Oxford UKA. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). . [] found the incidence of mucoid degeneration in their study population to be 1.0%.Most of their reported cases were incidental findings without contributory symptoms. mucoid degeneration acl symptoms. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. It also prevents excessive tibial medial and lateral rotation, as well as varus and valgus stresses [1]. Functional assessment was done by the same clinician using patient-related outcome measures (PROMs) using the self-questionnaire-based International Knee Documentation Committee (IKDC) score, Knee Society score (KSS), VAS score (for rest pain) and subjective satisfaction level. California Privacy Statement, It can cause pain and to a meniscal tear. By continuing to browse this site, you accept our, International Journal of Endocrine Oncology, International Journal of Hematologic Oncology, Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C, Mucoid metaplastic-degeneration of anterior cruciate ligament, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR, Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation, Makino A, Pascual-Garrido C, Roln A, Isola M, Muscolo DL, Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK, Mucoid cystic degeneration of the cruciate ligament, Mucoid degeneration of the anterior cruciate ligament, Arthroscopic management of mucoid degeneration of anterior cruciate ligament, Pandey V, Suman C, Sharma S, Rao S, Kiran Acharya K, Sambaji C, Mucoid degeneration of the anterior cruciate ligament: management and outcome, Mucoid degeneration of the anterior cruciate ligament: a case report and review of literature, 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, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J, Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament, Kim T-H, Lee D-H, Lee S-H, Kim J-M, Kim C-W, Bin S-I, Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament, Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA, Platelet-rich plasma: from basic science to clinical applications, Southworth T, Naveen N, Tauro T, Leong N, Cole B, The use of platelet-rich plasma in symptomatic knee osteoarthritis, Vogrin M, Rupreht M, Crnjac A, Dinevski D, Krajnc Z, Renik G, The effect of platelet-derived growth factors on knee stability after anterior cruciate ligament reconstruction: a prospective randomized clinical study, Partial anterior cruciate ligament ruptures: advantages by intraligament autologous conditioned plasma injection and healing response technique midterm outcome evaluation, Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears, Rating systems in the evaluation of knee ligament injuries, Hensen JJ, Coerkamp EG, Bloem JL, Schepper AMD, Association of mucoid degeneration of anterior cruciate ligament with knee meniscal and cartilage damage, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P, Anterior cruciate ligament mucoid degeneration: selecting the best treatment option, Zicaro JP, Yacuzzi C, Garcia-Mansilla I, Costa-Paz M, Nonsurgical treatment of partial ACL tears: intraarticular injection of platelet-rich plasma did not change the progression rate to knee instability, Seijas R, Ares O, Cusc X, lvarez P, Steinbacher G, Cugat R, Partial anterior cruciate ligament tears treated with intraligamentary plasma rich in growth factors, Long-term outcomes of primary repair of the anterior cruciate ligament combined with biologic healing augmentation to treat incomplete tears, McRobb J, Kamil KH, Ahmed I, Dhaif F, Metcalfe A, Influence of platelet-rich plasma (PRP) analogues on healing and clinical outcomes following anterior cruciate ligament (ACL) reconstructive surgery: a systematic review. Ghanasingh Fine Jewels, next to Dharam Palace, Gamdevi, Mumbai, Maharashtra, 400007, India, Galaxy Hospital, Kolar Road, Bhopal, Madhya Pradesh, 462042, India, Canadian Hospital, Abu Hail, Dubai, United Arab Emirates, You can also search for this author in The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case series. This is done arthroscopically (arthroscopic/key hole surgery). A common sports injury whichusually happens over time from normal wear and tear ofmuscles and tendons. As this improvement might not be entirely due to PRP, high-end comparative studies are needed to confirm its efficacy. Part of Usually there is no history of any significant trauma. After surgery patient is allowed to walk from the next day. T2-weighted sagittal view demonstrates localized fluid signal within the ACL (arrows). Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. ACL ganglion cyst occurs more frequently among relatively younger patients compared to mucoid degeneration. https://doi.org/10.1302/0301-620X.81B2.0810304, Article The minimum follow-up was 3 years. Evaluate the TCO of your PACS download >, 750 Old Hickory Blvd, Suite 1-260Brentwood, TN 37027, Focus on Musculoskeletal and Neurological MRI, The Anterior Meniscofemoral Ligament of the Medial Meniscus. A coordinator will follow up to see if Mayo Clinic is right for you. Mentioning: 2 - We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). 58th ed. This article belongs to the Special Issue on Radiation Therapy in the Treatment of Cancer < 1 2 3. Sequential intra-operative pictures (left to right): a Surgeon unable to pass the arthroscopy hook between the medial cortex of lateral femoral condyle and lateral border of mucoid ACL. Inclusion criteria was as follows: (1) clinicoradiological confirmation of MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee joint; (2) patients with less than 10 of varus or 5 of valgus deformity and (3) patients with no flexion contracture. Please check your URL or use the search form below. Once considered a rare disease, it is probably a less diagnosed condition of knee pain. Before an appointment, be prepared to answer the following questions: Mayo Clinic does not endorse companies or products. > Follow SCIRP. At arthroscopy, the ACL appeared homogenous, bulbous, and hypertrophied in all patients. Doctors and physical therapists will perform tests to gauge your knee's stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. 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. Skeletal Radiol 2001 Jun; 30(6): 312-5. ACL Reconstruction is a surgical procedure to reconstruct the ligament in the center of your knee in order torestore its function after an injury. American Journal of Sports Medicine. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, Additional Professor, Department of Orthopaedics, AIIMS Jodhpur, Jodhpur, Rajasthan, 342005, India, Senior Resident, Department of Orthopaedics, AIIMS Jodhpur, Jodhpur, Rajasthan, 342005, India. 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 ). Sports medicine & outpatient orthopedics. (2a) T1-weighted sagittal image demonstrates an enlarged, club-shaped anterior cruciate ligament (arrows). The authors declare that they have no competing interests. How common is mucoid degeneration of the ACL? Int J Sports Phys Ther 10(1):5261, PubMed This was confirmed at 2years follow-up, when the patients who underwent debulking showed a statistically significant improvement in in mean terminal flexion by 21.51 in group B (mean pre-operative: 96.3855.78; mean post-operative: 117.892.64) as compared with 5.02 in group A (mean pre-operative: 98.0934.79; mean post-operative: 103.114.1). New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. 10, No. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Intraosseous ganglion 6. . One MRI was reported as a possible ganglion cyst or mucoid degeneration of the ACL, whereas all others were reported as either partial or complete tears of the ACL. Su Chan Lee, Kyung Won . The Infona portal uses cookies, i.e. strings of text saved by a browser on the user's device. Arthroscopic debridement may help relieve the anterior knee pain. The treatment alternatives, indications for the planned procedure and risks were discussed with her in detail and an informed consent was obtained. Plain radiographs in lateral view (in standing) of the left knee of patient number 164 from group B (Left to Right): a Pre-operative radiograph for baseline position of posterior femur and tibia. It may lead to knee pain. Community. Indian J Orthop 46(5):561565. maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid In vivo elongation of the anterior cruciate ligament and posterior cruciate ligament during knee flexion. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. Non-traumatic thickening of the ACL was associated with osteoarthritis and meniscal tears in almost all cases and showed increased signal intensity and ill-defined borders simulating acute ligamentous tears. Mucoid degeneration of anterior cruciate ligament (ACL) 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. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. ACL Injury Grades. : tissue degeneration marked by conversion of cell substance into a glutinous substance like mucus. Platelet-rich plasma (PRP) is known to influence musculoskeletal healing through multiple growth factors. Why Do Cross Country Runners Have Skinny Legs? During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon tissue similar to a ligament that connects muscle to bone. DeLee JC, et al. J Bone Jt Surg [Br] 68-B:608609, Kang SN, Smith TO, De Rover WBS, Walton NP (2011) Pre-operative patellofemoral degenerative changes do not affect the outcome after medial Oxford unicompartmental knee replacement: a report from an independent centre. just over two decades ago [1], the interest in this condition has quickly gathered pace in the orthopaedic community. Google Scholar, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Exclusion criteria was as follows: (1) patients with a previous history of having undergone reconstruction, repair or debulking of the ACL in the ipsilateral knee; (2) patients with a history of any surgery in and around the ipsilateral or contralateral knee, or ipsilateral hip or ankle joints; (3) patients with inflammatory arthritis; (4) patients with musculoskeletal and learning disorders and (5) patients diagnosed with mucoid degeneration of the PCL radiologically.