in 1999 [1]. PMC Orthopaedics & Traumatology: Surgery & Research. Discussion: By using this website, you agree to our Disclaimer. reported the largest percentage of patients (27.5%) with a positive pivot test. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. Along with that, it also controls the internal rotation. https://doi.org/10.4055/cios.2018.10.3.307, University Hospitals of Derby and Burton, Uttoxeter Rd, Derby, DE22 3NE, UK, Trauma and Orthopaedic Speciality Trainee, West Midlands Deanery, Birmingham Rotation, Birmingham, UK, University Hospitals Plymouth NHS Trust, Plymouth, UK, University of Alexandria, Alexandria, Egypt, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry, CV2 2DX, UK, You can also search for this author in The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. The mean MINORS score was 9.5 (range 412). Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. government site. Knee Surgery & Related Research For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. ACL debridement was partial in all studies except for those by Lintz et al. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Level of evidence: Methods: Conditions that resembles the clinical findings are: Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. The success of treatment for MDACL and the subsequent risk of instability is not known. Hypothesis: The presence of intraligamentous mucoid degeneration in the ACL is demonstrated as a source of knee pain without instability and partial ACL debridement did not preclude adequate knee stability. Orthopedics; anterior cruciate ligament; arthoscopy. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. 2012;4 (2): 167-70. 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 ). Bethesda, MD 20894, Web Policies -. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. 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. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Keywords: 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. mucoid degeneration of acl mri. Check for errors and try again. California Privacy Statement, Postoperative clinical laxity was common, however, symptomatic instability was not. 2010 Jun 1;96(4):400-6. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. NCI CPTC Antibody Characterization Program. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. There is no consensus on treatment and evidence is scarce. The mean age of patients ranged from 31 to 78years. 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. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. 2023 BioMed Central Ltd unless otherwise stated. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Part of Careers. 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. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). Knee Surg & Relat Res 33, 26 (2021). Unauthorized use of these marks is strictly prohibited. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Results: PubMed official website and that any information you provide is encrypted Would you like email updates of new search results? The site is secure. The https:// ensures that you are connecting to the This site needs JavaScript to work properly. 6. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. The total number of patients with symptomatic instability was 18 out of 288 (6%). They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. J Sports Med Phys Fitness 48(4):483487, PubMed did not report on this. Physiotherapy. Anterior knee pain is the more common complaint. Knee Surg Sports Traumatol Arthrosc. Springer Nature. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). https://doi.org/10.1046/j.1445-2197.2003.02748.x, Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a systematic review. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. Mucoid degeneration of the anterior cruciate ligament. Its signal is increased on all sequences. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. https://doi.org/10.2214/ajr.182.5.1821283, Article Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. PubMed 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. The origin of MDACL may be degenerative or traumatic. Bethesda, MD 20894, Web Policies Epub 2021 Mar 8. At the time the article was created Frank Gaillard had no recorded disclosures. 2004;182(5):12831287. All rights reserved. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. All nine studies were case series; six were retrospective and three were prospective studies. Patients will . Anatomopathology samples were collected in 18 cases. I get PT and acupuncture, have had several epidural injections, and am trying hard to avoid osteoporosis meds (was on bisphosphonates for many years many years ago) as well as spinal fusion. 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 Provided by the Springer Nature SharedIt content-sharing initiative. This appearance can mimic acute or chronic interstitial partial tears of the ligament. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. 2018;4(4):875-80. Epub 2013 Aug 27. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. The https:// ensures that you are connecting to the 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. and Ventura et al. All patients (100%, n=11) reported an improvement in pain. Arthroscopic findings. sharing sensitive information, make sure youre on a federal However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, most pronounced at 6-7 and small disc herniations at 5-6 and C4-5, with slight interval progression at 5-6. . Pain was posterior in 23 knees (80%). The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. HHS Vulnerability Disclosure, Help 2 ). 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. official website and that any information you provide is encrypted -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. 2001;17(9):E37. Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. Mucoid degeneration of the anterior cruciate ligament. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Postoperative recovery was four weeks on average. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Score: 4.7/5 (45 votes) . Open Grey database was searched for grey literature using the same keywords. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. What causes mucoid degeneration of ACL? Twelve partial and 17 total resections were performed. Later studies reported that changes consist of mucoid Results degeneration, neovascularisation, and tendon sheath hyper- Nineteen patients met the inclusion criteria and were inclu- trophy. [18] did not comment on an association between MDACL and chondral or meniscal lesions: after the exclusion of that report, the total number of patients with associated chondral lesions was 226 out of 275 patients (82%) and 190 patients had meniscal lesions (69%). Bone and joint imaging. Arch Orthop Trauma Surg. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. in 1999 [ 1 ]. This is a rare pathological condition, in which, there is increased signal from within the ligament. Each study was scored 02 on each question, with a global ideal score of 16. Imaging: Plain radiographs Arthroscopic findings. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Preoperative magnetic resonance imaging (MRI) scan. Unable to load your collection due to an error, Unable to load your delegates due to an error. TS designed the project, literature search and wrote the manuscript. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). 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. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Introduction: Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first described in the literature in 1999.1 Since then, MD-ACL has been recognized as a pathology present on between 0.7% and 5.3% of magnetic resonance images performed for knee pain.2 MD-ACL is thought to be part of a spectrum of ACL disease that can range from ganglion cysts to MD.3 MD-ACL can either be primary (idiopathic . Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. 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.