mucoid degeneration of acl physiotherapydr liu's medical acupuncture clinic
the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. 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. . However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. 2013;15(1). Federal government websites often end in .gov or .mil. Ligaments hold our bones together and allow us to bend, twist, pivot and rapidly accelerate and decelerate and yet maintain the stability of our joints. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. The minimum follow-up was 3 years. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. An official website of the United States government. Generally, we know little about this condition. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Signal intensity of the anteromedial bundle (AMB) or posterolateral bundle (PLB) graft standardized to the intensity of the PCL was defined as signal intensity ratio (SIR). sharing sensitive information, make sure youre on a federal For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. and transmitted securely. Conclusions. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. PubMed Central It results in postoperative laxity, but rarely in frank instability. Resnick D, Kransdorf MJ. The prevalence of MDACL on magnetic resonance imaging (MRI) ranges from 1.8 to 5.3% [4, 5]. -, Fealy S, Kenter K, Dines JS, Warren RF. 2023 BioMed Central Ltd unless otherwise stated. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. The origin of MDACL may be degenerative or traumatic. PubMed Preoperative and postoperative results of eleven patient were compared. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. 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. The success of treatment for MDACL and the subsequent risk of instability is not known. 6. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. 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. CAS Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. official website and that any information you provide is encrypted Besides, the patient may also have trouble in moving. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. 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. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Hide glossary Glossary. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. Clipboard, Search History, and several other advanced features are temporarily unavailable. 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. Noninfiltrating synovial cysts of the ACL were excluded. See this image and copyright information in PMC. The patient presented with extension block of the knee. and transmitted securely. (10%) and highest in the study of Ventura et al. The appearance can mimic acute or chronic interstitial partial tears of the ACL. However, in most studies a proportion of patients simultaneously underwent other arthroscopic procedures for associated pathological knee conditions (44% meniscectomies in the study of Cha et al.). . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Mucoid degeneration of ACL. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Unlike meniscal tears and chondral defects, the mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain and there have been no case reports of mucoid degeneration of both the ACL and the posterior cruciate ligament (PCL). Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. J Orthop. and transmitted securely. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. J Orthop. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. Unauthorized use of these marks is strictly prohibited. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Please enable it to take advantage of the complete set of features! ACL debridement was partial in all studies except for those by Lintz et al. National Library of Medicine Level of evidence: Knee Surg Sports Traumatol Arthrosc 21(3):658663. Bookshelf MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. Skeletal Radiol. 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.2008.02.004, Morice A, Coupry A, Lintz F, Robert H (2013) Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Would you like email updates of new search results? Please enable it to take advantage of the complete set of features! 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 ]. Arthroscopic findings. Sweed, T., Mussa, M., El-Bakoury, A. et al. PubMed This ranged from 90 to 95% in all studies, except in the report by Kim et al., where only 53.8% of patients (57/106) had complete pain relief after surgery. A long duration of non-specific knee pain in a patient should be evaluated with MRI. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. 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]. 2. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Careers. This makes it difficult to relate the improvement of symptoms to ACL debridement. At the time the article was created Frank Gaillard had no recorded disclosures. There was strong association with chondral lesions and meniscal tears. Rehabilitation, speech therapy, crenotherapy. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. -, Hodler J, Haghighi P, Trudell D, Resnick D. The cruciate ligaments of the knee: Correlation between MR appearance and gross and histologic findings in cadaveric specimens. Mucoid degeneration of the anterior cruciate ligament. Unable to load your collection due to an error, Unable to load your delegates due to an error. Partial/Total ACL resection arthroscopically- There is marked improvement in the range and reduced posterior pain, but at the cost of increased post-operative knee laxity. 2007;90(3):1923. On clinical examination, the active range of motion showed a flexion deficit. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). What is myxoid degeneration treatment? There is no consensus on treatment and evidence is scarce. 2004;182 (5): 1283-7. mucoid degeneration of acl mri. GG and AM interpreted the results and reviewed the manuscript. government site. It may lead to knee pain. 2001;17(9):E37. 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 . A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Tamer Sweed. Questions just answered: mucoid degeneration of acl physiotherapy. Knee Surg & Relat Res 33, 26 (2021). The extracted data were heterogeneous in terms of outcome assessment. Other theories include Degenerative theory- MD could occur due to ageing.[3]. All patients (100%, n=11) reported a good to very good surgery satisfaction. AJR Am J Roentgenol. -Evaluated and planned treatment protocol in accordance with physician. This may support the theory that it is a degenerative process. Anterior Cruciate Ligament, is an important structure of the knee joint. 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. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. 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. A total of 313 knees in 292 patients were included. There was strong association between degenerative changes and MDACL (82% having chondral and 69% meniscal lesions), which might suggest that MDACL is a degenerative process. TS designed the project, literature search and wrote the manuscript. Ahuja A, Parekh C, Salomon A, Lawande M, Daftary A. Skeletal Radiol. For non-comparative studies, this consists of eight questions. At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Mucoid degeneration of the anterior cruciate ligament: a case report. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. [Diagnosis and treatment of anterior cruciate ligament cysts]. The https:// ensures that you are connecting to the [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Any discrepancy was resolved by the senior author. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. https://doi.org/10.1016/j.jajs.2015.12.001, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J (2018) Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. What causes mucoid degeneration of ACL? MM and A performed the literature search, and data analysis. volume33, Articlenumber:26 (2021) Fourteen knees (48%) had limited flexion, on average 97 degrees. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms.