The cruciate ligaments control the back and forth motion of your knee. 2). We believe that meniscal mucoid degeneration with tear is not uncommon. We reviewed previous reports and summarized clinical features and symptoms, including those found in our case. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a This study holds clinical significance in terms of the very limited literature available on the role of MD-ACL in outcomes of patients undergoing UKA. Mucoid degeneration of ACL - Osteoporosis - inspire.com It is postulated that mucoid degeneration may be a predisposing factor to the formation of ACL ganglion cysts . With debulking of MD-ACL being a relatively newer concept and insufficient data backing the eventual stability of the ACL, the surgeons primarily performed UKA without debulking in MD-ACL, until December 2018. INTRODUCTION Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a well-recognized pathology characterized by the degradation of collagen fibers and infiltration of a . Physiotherapy. was the primary surgeon and was responsible for the conceptualization, methodology, supervision, writing review and editing. 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 What happens if you dont get surgery on a torn ACL? Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. M.P. Subsequently, controlled debulking of the posterolateral fibers was done using a 15-number blade until it was possible to tug at the ACL by passing a hook between the lateral femoral condyle and the posterolateral fibres of the ACL (Fig. This article belongs to the Special Issue on Radiation Therapy in the Treatment of Cancer < 1 2 3. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Setback to comeback: Twin sisters return to the basketball court after ACL tears, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, NSF Certified for Sport Nutritional Supplements. These findings were in line with the findings published by Cha etal. This is a 79-year old woman with recently found asymptomatic left hydronephrosis. The soft-tissue thickening and increased signal intensity along the course of the ligament with either form of cyst may be confused with the appearance of an ACL tear. [7] have documented the presence of flexion contracture, we did not notice the same in any patient from the recruited sample size. J Arthosc 6:322, 1990. In: Current Medical Diagnosis & Treatment 2019. Anterior Cruciate Ligament (ACL) Injury or Tear - Hopkins Medicine Histopathological confirmation of mucoid degeneration was obtained in all 442 patients. Google Scholar, White SH, Ludkowski PF, Goodfellow JW (1991) Anteromedial osteoarthritis of the knee. The samples collected from the five hospitals were 122 (group A: 58; group B: 64), 68 (group A: 35; group B: 33), 94 (group A: 46; group B: 48), 83 (group A: 41; group B: 42) and 75 (group A: 36; group B: 39), respectively. 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. To summarize, debulking of mucoid ACL in patients undergoing unicompartmental knee arthroplasty significantly reduces the rest pain and improves the final range of motion of the knee joint, subsequently improving the overall functional and clinical outcome of the patient and resulting in greater patient satisfaction. Before an appointment, be prepared to answer the following questions: Mayo Clinic does not endorse companies or products. 6 Antonacci VP, Foster T, Fenlon H, Harper K, Eustace S: Technical report: CT-guided aspiration of anterior cruciate ligament ganglion cysts. By a paramedian incision and mini-midvastus arthrotomy, the joint was exposed. A physical therapist will teach you exercises that you will perform either with continued supervision or at home. It can cause pain and to a meniscal tear. Connect with thousands of patients and caregivers for support, practical information, and answers. DOC Operative Note What is mucoid degeneration of the meniscus? The most common cause of meniscus tears is age related degeneration. Injury prevention. It also prevents excessive tibial medial and lateral rotation, as well as varus and valgus stresses [1]. https://doi.org/10.1302/0301-620X.73B4.2071640, Pandit H, Gulati A, Jenkins C (2011) Unicompartmental knee replacement for patients with partial thickness cartilage loss in the affected compartment. 2015;23:283. . Mucoid degeneration of the anterior cruciate ligament (ACL) is a clinical condition observed primarily in middle-aged patients presenting with knee pain and limited range of motion in the absence of symptoms of instability or a significant history of trauma [].ACL mucoid degeneration causes knee pain less frequently than meniscal tears or chondral defects [17, 18] and has been rarely reported . Details on the top journals, universities, and authors on t. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. With the advent of the mobile-bearing UKA system, the predilection towards this surgery is on an upward trend. https://doi.org/10.20546/ijcrar.2016.411.003, Chudasama CH, Chudasama VC, Prabhakar MM (2021) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. They are frequently seen at joints and tendons of the wrist but are rare in the region of knee joint. AskMayoExpert. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. [2]. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. MAUDE Adverse Event Report: GENZYME BIOSURGERY (RIDGEFIELD) SYNVISC ONE . Proton density-weighted sagittal demonstrates a diffusely increased size of the ACL with ill-defined increased signal and interspersed intact ACL fibers. Clinical significance of T2*-weighted gradient-echo MRI to monitor All 5 patients under- went arthroscopic surgery. 1). These include pristine lateral and patellofemoral compartments, correctable varus deformity, less than 1015 of fixed flexion deformity, flexion of more than 100, and functionally intact collateral ligaments and cruciates [10,11,12,13,14,15]. Often the diagnosis can be made on the basis of the physical exam alone, but you may need tests to rule out other causes and to determine the severity of the injury. (Tr. Predetermined inclusion and exclusion criteria were used for sample collection. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. Culmination of these results meant that even the patient satisfaction at 2years follow-up was better in the debulking group. A Systematic Summary of Systematic Reviews on the Topic of the Anterior A steeper PTS angle, decreased notch width index, and transverse notch angle are significantly associated with the presence of mucoid degeneration of the anterior cruciate ligament in symptomatic MD-ACL patients. At arthroscopy, the ACL appeared homogenous, bulbous, and hypertrophied in all patients. The MR-findings of mucoid degeneration of the ACL include: an ill-defined ACL; an increased ligamentous girth Do any specific movements seem to improve or worsen your symptoms? New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Home | About | Contact | Copyright | Report Content | Privacy | Cookie Policy | Terms & Conditions | Sitemap. Both the patient groups were matched for age, gender, pre-operative ROM and functional scores, minimising any confounding effect in data collection. K Munde: Substantial contributions to the design of the work, analysis of the data for work, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Depending on the severity of your injury, you may be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon). Make a donation. 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. Results: Visual analogue scale and Lysholm scores improved compared with preoperative scores, along with strength (anterior drawer test and Lachman test). Modalities such as icing, joint mobilization, and massage can provide short-term pain relief and reduce swelling. If present in a patient undergoing unicompartmental knee arthroplasty, it can deteriorate the final outcome. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Anyone else have this and how was it treated if at all? Knee Surg Relat Res 33(1):26. https://doi.org/10.1186/s43019-021-00110-6, Kennedy JA, Mohammad HR, Mellon SJ, Dodd CAF, Murray DW (2020) Age stratified, matched comparison of unicompartmental and total knee replacement. Journal of the American Academy of Orthopaedic Surgeons. 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. The pain and disability associated with an ACL injury prompt many people to seek immediate medical attention. Arthroscopic management of mucoid degeneration of anterior cru No writing assistance was utilized in the production of this manuscript. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. Am J Roentgenol 182(5):12831287. Google Scholar, Lee JW, Ahn JT, Gwak HG, Lee SH (2021) Clinical outcomes of arthroscopic notchplasty and partial resection for mucoid degeneration of the anterior cruciate ligament. PDF Plaintiff, MAGISTRATE JUDGE vs. JONATHAN D. GREENBERG A case of mucoid degeneration of the anterior cruciate ligament (ACL) is reported based on specific imaging features on MRI. However, the presence of MD-ACL means the associated impingement symptoms have the propensity to continue despite the arthroplasty. statement and Sagittal T1-weighted (1a) and fat-suppressed proton density-weighted (1b) images. J Sports Med Phys Fit 48(4):483487, CAS strings of text saved by a browser on the user's device. Despite recent developments suggesting that debulking of MD-ACL does not cause instability [8], the involvement of another surgery that can directly be impacted by it complicates the decision making. 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 . Methodology: Five patients who were diagnosed as a case . CIOS :: Clinics in Orthopedic Surgery Sports medicine & outpatient orthopedics. Let others know if this answer was helpful As we age, the connections between the collagen fibers that make up the meniscus begin to deteriorate, causing failure of the structure and tears due to stresses in the joint. 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. PubMed Central (7a) Intra-articular extension of a cruciate ligament ganglion. Usually there is no history of any significant trauma. 2). Anterior Cruciate Ligament (ACL) Rehabilitation - Physiopedia Generally, we know little about this condition. https://www.uptodate.com/contents/search. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Knee Surgery, Sports Traumatology, Arthroscopy mucoid degeneration of acl mri. . A pre-study power analysis was done for a minimum sample size of 400, using dependent and independent variables involved in the study outcome. What is thickening of the ACL? - AnswersAll These patients who underwent UKA with debulking of MD-ACL were included in group B (nb=226). : tissue degeneration marked by conversion of cell substance into a glutinous substance like mucus. Among other conditions - osteoarthritis, osteopenia, spondylolisthesis- an MRI report showed "severe mucoid degeneration of the ACL" in my left knee. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. The ACL can be injured or torn in a number of different ways. At the time of the injury, a "pop" or "snap . 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). Purpo. What does mucoid degeneration of posterior horn of medial - HealthTap A total of 488 patients diagnosed with MD-ACL (clinically and radiologically) underwent surgery during this period, of which 46 patients (9.43%) were lost to the minimum 2-year follow-up criteria or to matching of groups. https://doi.org/10.1302/0301-620X.93B4.25562, Mittal A, Meshram P, Kim WH, Kim TK (2020) Unicompartmental knee arthroplasty, an enigma, and the ten enigmas of medial UKA.
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