The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). ACL ganglion cyst at arthroscopy may appear as a cystic mass with . Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. FOIA Federal government websites often end in .gov or .mil. eCollection 2021. CAS Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. 2006;69(9):44952. Unable to load your collection due to an error, Unable to load your delegates due to an error. No treatment is usually required. 3. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Cho SD, Youm YS, Lee CC et-al. The extracted data were heterogeneous in terms of outcome assessment. 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]. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. J Knee Surg. Epub 2008 Apr 18. Its signal is increased on all sequences. sharing sensitive information, make sure youre on a federal Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. HHS Vulnerability Disclosure, Help Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. J Clin Epidemiol 62(10):10061012. The appearance can mimic acute or chronic interstitial partial tears of the ACL. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. 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. in 1999 [ 1 ]. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Roberts CC, Towers JD, Spangehl MJ et-al. Mucoid degeneration of the anterior cruciate ligament. Symptomatic ACL mucoid degeneration in middle-age athletes. All patients (100%, n=11) reported a good to very good surgery satisfaction. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. 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 . All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). 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. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. 2011. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. sharing sensitive information, make sure youre on a federal Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Methods: The minimum follow-up was 3 years. PMC Tamer Sweed. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. bling. A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. IV (retrospective cohort study). Introduction: MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. Before 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 In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. 1992;159(2):35760. Unable to process the form. 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. J Arthrosc Joint Surg 3(1):2833. All patients (100%, n=11) reported an improvement in pain. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. to 44% in the study of Cha et al. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. Orthop Traumatol Surg Res. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. 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. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. 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. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. 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. . At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Bookshelf https://doi.org/10.1007/s00167-011-1433-0, Article Arthroscopy. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. Arthroscopy. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Rehabilitation, orthophony, crenotherapy. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. government site. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. This site needs JavaScript to work properly. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Noninfiltrating synovial cysts of the ACL were excluded. Hypothesis: 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. This systematic review has some limitations. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Preoperative magnetic resonance imaging (MRI) scan. 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). Arthroscopy. Postoperative pain relief was reported in seven studies. HHS Vulnerability Disclosure, Help 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. National Library of Medicine Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. reported total resection of the ACL in 68% of patients: one young patient had disabling instability and subsequent ACL reconstruction. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Level of evidence: Any discrepancy was resolved by the senior author. -Evaluated and planned treatment protocol in accordance with physician. Bookshelf Methods: The retrospective study by Kim et al. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Arthroscopic findings. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Ventura et al. Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate ligament. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate J Orthop. Average patient age was 49 (22 to 68) years. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. [17] do not mention whether any patients underwent biopsy (Table 3). Skeletal Radiol. The mean MINORS score was 9.5 (range 412). Indian J Orthop 48(2):197202. 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. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al.
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