mucoid degeneration of acl physiotherapy

Postoperative pain relief was reported in seven studies. Seventeen females (67%) and eight males (33%) were included in the final analysis. PROSPERO. J Knee Surg. Part of Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. 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. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. Score: 4.7/5 (45 votes) . We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. The anterior cruciate ligament (ACL) is an important ligament in the knee. TS designed the project, literature search and wrote the manuscript. Mumbai, Maharashtra, India. what causes mucoid degeneration of acl. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. The aetiology of MDACL is not clearly understood. Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. Unauthorized use of these marks is strictly prohibited. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Individuals were included in the study if they had had complete MRIs of the affected knee at baseline and at 4-year follow-up, had thigh MRIs at baseline and had no additional surgery in the meantime. 2011 Jun;25(6):650-2. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Pan African Medical Journal. The need for simultaneous or delayed ACL reconstruction should be discussed with patients in case total resection of the ACL is to be performed, particularly in young active patients. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. PubMed Central sharing sensitive information, make sure youre on a federal You can read more if you want. Arthroscopic findings. We report a case of a patient with mucoid degeneration of the ACL, presenting with posterior knee pain and no history of a major knee trauma. The site is secure. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. The extracted data were heterogeneous in terms of outcome assessment. They reported that a biopsy indicated mucoid degeneration and a relief of symptoms could be obtained through arthroscopic partial resection of the ligament. ADVERTISEMENT: Supporters see fewer/no ads. A 48-year-old-male patient presented with knee pain and limitation of motion. Bookshelf AJR Am J Roentgenol. Unauthorized use of these marks is strictly prohibited. official website and that any information you provide is encrypted Introduction: I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Bookshelf Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. J Orthop. JBR-BTR. Mucoid degeneration of the anterior cruciate ligament. Arthroscopy 20(2):141146. . Characteristic: "celery stalk" appearance. 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. 1992;159(2):35760. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Average patient age was 49 (22 to 68) years. Unable to process the form. Mucoid degeneration of the anterior cruciate ligament: a case report. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. (48.2% (14/29 patients) with symptomatic instability), which may be due to the large number of patients with total resection of the ACL (58.6% (17 out of 29 patients)) (Table 4). GG and AM interpreted the results and reviewed the manuscript. Unable to load your collection due to an error, Unable to load your delegates due to an error. Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee Cho SD, Youm YS, Lee CC et-al. 2011 Mar;25(3):262-5. Physiotherapy. Eight studies reported postoperative instability. 4. ACL tears don't heal as such. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. 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). Postoperative recovery was four weeks on average. Methods: On clinical examination, the active range of motion showed a flexion deficit. Methods From January 2012 to August 2013, 32 knees (24 females and 8 males with left knee of 14 and 18 of right) were diagnosed with mucoid degeneration of the ACL and underwent arthroscopic treatment, all of whom with a mean age of 58.817.97 years (42-74 years). The clinical presentation is one of posterior pain with limited flexion. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. 2. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Orthopaedics & Traumatology: Surgery & Research. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Results: Introduction: Bergin et al. In the nine included studies, four different scores were used for outcome assessment. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. It results in postoperative laxity, but rarely in frank instability. 2007;90(3):1923. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. FOIA Radiology. 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 . California Privacy Statement, 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. 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 ). ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . Arthroscopy. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. sharing sensitive information, make sure youre on a federal https://doi.org/10.1186/s43019-021-00110-6, DOI: https://doi.org/10.1186/s43019-021-00110-6. 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. 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. Learn how we can help 704 views Reviewed >2 years ago Thank 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. Before in this condition your acl (anterior cruciate ligament) filled with jelly like material and it thickened so space in intercondylar resion of knee joint is reduced. Magn Reson Imaging Clin N Am. That is usually the journal article where the information was first 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. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Mucoid degeneration of the anterior cruciate ligament. 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. Disclaimer. PubMed 2011 Aug 1;19(8):1326-33. Conclusion: Treatment of ACL mucoid degeneration by this modality is effective in preventing recurrence, post-operative laxity and provides better functional outcome compared to the classical partial resection of the degenerated ACL. Hypothesis: Knee Surg Sports Traumatol Arthrosc 21(3):658663. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. The authors declare that they have no competing interests. Epub 2013 Aug 27. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. This appearance can mimic acute or chronic interstitial partial tears of the ligament. The author(s) read and approved the final manuscript. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Knee Surgery, Sports Traumatology, Arthroscopy. 2011. mucoid degeneration of acl mri. 2008;24(6):642649. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. A total of nine studies were eligible for review. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. 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. 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 magnetic resonance imaging (MRI) scan. There was a high rate of association between degenerative lesions and MDACL, ranging from 39 to 96%. 2018;4(4):875-80. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. 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. A total of 313 knees in 292 patients were included. Epub 2008 Dec 17. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. The mean follow up ranged from 13 to 72months. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. For non-comparative studies, this consists of eight questions. and transmitted securely. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Before and transmitted securely. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. It is a chronic degenerative change of a bulky ACL that may lead to notch impingement syndrome in the absence of instability symptoms and significant trauma history [ 1, 2, 3, 4 ]. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Mucoid degeneration of the anterior cruciate ligament. PubMed Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. Individuals with mucoid degeneration of the ACL were excluded. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Intact fibers are best seen on T2WI. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Despite the low rate of complications in all studies, there was a high incidence of postoperative knee laxity, demonstrated by a positive Lachman test, in most studies. Conclusion: Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. National Library of Medicine Epub 2011 Feb 18. in 1999 [ 1 ]. What Is Mucoid Degeneration of the ACL? Fig. Sweed, T., Mussa, M., El-Bakoury, A. et al. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). Accessibility Before . Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Meniscectomy was undertaken in 11 cases (41%). 2012;4 (2): 167-70. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. 2004;182 (5): 1283-7. Any discrepancy was resolved by the senior author. Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. https://doi.org/10.2214/ajr.182.5.1821283, Article Glossary of terms for musculoskeletal radiology. There was strong association with chondral lesions and meniscal tears. Bone and joint imaging. Please enable it to take advantage of the complete set of features! Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was debrided. The https:// ensures that you are connecting to the Hotchen AJ, Demetriou C, Edwards D, Melton JTK. Pain was posterior in 23 knees (80%). . Arthroscopic debridement of the ACL results in satisfactory pain relief and improvement in knee outcome scores. The ligament is mainly responsible for restraining anterior translation of knee. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. : A Meta-Analysis. 8600 Rockville Pike 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Epub 2021 Nov 24. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. 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. The https:// ensures that you are connecting to the A total of 313 knees in 292 patients were included in the nine studies. MM and A performed the literature search, and data analysis. Physiotherapy. Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons. Method. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). All patients (100%, n=11) reported an improvement in pain. FOIA This bicentric, retrospective cohort study with an average follow-up of 6years involved 27 patients (29 knees) presenting with symptomatic ACL mucoid degeneration validated by magnetic resonance imaging (MRI). Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms government site. (10%) and highest in the study of Ventura et al. PMC maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid In the Lintz study, total resection of the ACL was performed in 17 out of 29 knees, while in the Ventura study total resection was performed in 17 out of 25 patients. Arch Orthop Trauma Surg. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. National Library of Medicine In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). Symptomatic ACL mucoid degeneration in middle-age athletes. 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. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. 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. 5. 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 https://doi.org/10.1302/0301-620X.81B2.0810304, Article The .gov means its official. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Coronal proton density-weighted magnetic resonance, Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate, Sagittal proton density-weighted magnetic resonance, Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased, Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate, Pre-debridement arthroscopic view showing yellowish. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. reported on the co-existence of mucoid degeneration and ganglia of the ACL. The .gov means its official. Rehabilitation, speech therapy, crenotherapy. 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. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. This study concerns complete ACL resec . Provided by the Springer Nature SharedIt content-sharing initiative. Before I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Careers. The site is secure. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. https://doi.org/10.1016/j.arthro.2003.11.030, Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients.Materials and MethodsBetween December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis . Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. The origin of MDACL may be degenerative or traumatic. Level of evidence: HHS Vulnerability Disclosure, Help Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. 2011. just over two decades ago [], the interest in this condition has quickly gathered pace in the orthopaedic community.Little is known about this condition that affects 1.8-5.3% of the population as per magnetic resonance imaging (MRI) diagnosis [2, 3]. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. Rehabilitation, orthophony, crenotherapy. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Clin Orthop Surg. MRI - Interstitial ACL tear With Mild knee joint effusion ,No evidence of discontinuation of fibre Can Interstitial ACL tear heal without surgery Asked for Male, 22 Years 78 Views v Dr. Abhishek Kaushik Joint Replacement Surgeon | Delhi 1/1 people found this helpful Hi. The minimum follow-up was 3 years. 2006;69(9):44952. [17] do not mention whether any patients underwent biopsy (Table 3). To our knowledge, this is the first systematic review to look into the results of the management of MDACL. in 1999 [1].

Wrhu Radio Contact, Everydays: The First 5000 Days High Resolution, Articles M