mucoid degeneration of acl physiotherapy

The pathogenesis remains controversial. Am J Roentgenol 182(5):12831287. That is usually the journal article where the information was first stated. Clipboard, Search History, and several other advanced features are temporarily unavailable. In six of the nine studies [6, 14, 16,17,18], arthroscopic debridement of the ACL was associated with simultaneous partial meniscectomy; this ranged from 13% in the study of Morice et al. J Chin Med Assoc. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Patients will . Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. Unauthorized use of these marks is strictly prohibited. Papadopoulou P. The celery stalk sign. Knee Surg Sports Traumatol Arthrosc. 2. Disclaimer. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Physiotherapy. FOIA Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. The mean follow up ranged from 13 to 72months. Therefore, indications for ACL resection must be carefully selected. 2006;69(9):44952. 2018 Apr;34(4):1054-1059. doi: 10.1016/j.arthro.2017.10.039. Orthop Traumatol Surg Res 96(4):400406, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Pain was posterior in 23 knees (80%). At the time the article was created Frank Gaillard had no recorded disclosures. J Bone Joint Surg Ser B 81(2):304305. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Bethesda, MD 20894, Web Policies The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. All patients (100%, n=11) reported a good to very good surgery satisfaction. Clipboard, Search History, and several other advanced features are temporarily unavailable. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. to 44% in the study of Cha et al. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. All patients (100%, n=11) reported an improvement in pain. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. volume33, Articlenumber:26 (2021) Mucoid degeneration of the anterior cruciate ligament. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. There was a high rate of association between degenerative lesions and MDACL, ranging from 39 to 96%. sharing sensitive information, make sure youre on a federal Cite this article. Methods: 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. 2007;15 (1): 73-86. 8600 Rockville Pike Mucoid degeneration of A C L is more common and literature has also reported many cases, but for PCL only few cases have been reported in English literature. 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. Initially, partial weightbearing is allowed. Clipboard, Search History, and several other advanced features are temporarily unavailable. Multiple theories have been put forth that explains the pathological disorganization in the collagen fibers of the Anterior Cruciate Ligament, such as synovial, traumatic, and degenerative, "Synovial theory- states that there is accumulation of synovial fluid inside the substance of ACL in a herniated pouch of synovium. statement and 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 2008;24(6):642649. Anterior cruciate ligament mucoid degeneration. Hypothesis: Epub 2010 May 8. Before Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Along with that, it also controls the internal rotation. Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. MeSH PubMed Would you like email updates of new search results? On clinical examination, the active range of motion showed a flexion deficit. Arch Orthop Trauma Surg. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. report that one patient had ACL reconstruction simultaneously after the ACL debridement. The https:// ensures that you are connecting to the This study concerns complete ACL resec 1992;159(2):35760. J Chin Med Assoc. 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. Twelve partial and 17 total resections were performed. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. . : A Meta-Analysis. 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. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. MeSH 2011. 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. Conclusions. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. official website and that any information you provide is encrypted Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. This site needs JavaScript to work properly. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. MM and A performed the literature search, and data analysis. (61years), which was the largest study and represented more than one third of the total patients included in this review. Federal government websites often end in .gov or .mil. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. ACL debridement was partial in all studies except for those by Lintz et al. J Orthop. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. You can read more if you want. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. Privacy and transmitted securely. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. No reconstruction was performed at the same time. J Clin Epidemiol 62(10):10061012. This series describes the clinicoradiological presentation of patients with mucoid ACL, partial arthroscopic debridement of ACL and outcomes. 2. 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. It is commonly identified on MRI in association with other pathological findings and can be confused with partial ACL tears. 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. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. Some case reports have been published; however, it is difficult to diagnose and is often underdiagnosed or misdiagnosed because of its pathophysiological ambiguity. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. Federal government websites often end in .gov or .mil. Indian J Orthop. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Arthroscopy 20(2):141146. PMC 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. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. Clin Orthop Surg. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Mucoid degeneration of the anterior cruciate ligament. Cookies policy. The primary intervention was arthroscopic ACL debridement in eight studies; this was combined with notchplasty in cases of impingement with the lateral wall of the notch in five studies [6, 14, 16,17,18] (Table 3). proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. Truncation means that the . Anterior Cruciate Ligament, is an important structure of the knee joint. No treatment is usually required. 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. Orthopaedics & Traumatology: Surgery & Research. Before Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. . All nine studies were case series; six were retrospective and three were prospective studies. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT 2,375 views Sep 15, 2019 23 Dislike Dr. Prateek Joshi- Ortho 1.02K subscribers Notice Age-restricted video (based on Community Guidelines). On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. 2022 Oct 23;34(1):40. doi: 10.1186/s43019-022-00169-9. The .gov means its official. 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). Eight studies reported postoperative instability. 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. . Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). 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). Khanna et al. In most cases Physiopedia articles are a secondary source and so should not be used as references. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. Discussion: Skelet Radiol 30(6):312315. Preoperative magnetic resonance imaging (MRI), Fig. Arthroscopic debridement of the ACL resulted in good pain relief and improved range of movement in all studies, with postoperative improvement in the knee scores. Other theories include Degenerative theory- MD could occur due to ageing.[3]. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Careers. https://doi.org/10.1302/0301-620X.81B2.0810304, Article The total number of patients with symptomatic instability was 18 out of 288 (6%). Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. 4. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-3615, Case 11: with Hoffa fat pad ganglion cyst, Case 12: tibial nerve schwannoma and ACL mucoid degeneration, Case 1: Complete ACL tear and meniscal tears, Case 2: Anomalous insertion of the medial meniscus, View Frank Gaillard's current disclosures, see full revision history and disclosures, anterior cruciate ligament ganglion cysts, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Mucoid degeneration of the anterior cruciate ligament, congenital or acquired synovial tissue entrapment between ACL fibers. Federal government websites often end in .gov or .mil. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. It results in postoperative laxity, but rarely in frank instability. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Keywords: Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42018087782). Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. It can cause pain and to a meniscal tear. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. However, symptomatic instability was not common. Bethesda, MD 20894, Web Policies An official website of the United States government. Epub 2021 Nov 24. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. (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). Federal government websites often end in .gov or .mil. 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. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. 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. 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. Instrumental treatment. and transmitted securely. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Please enable it to take advantage of the complete set of features! Arthroscopy. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. Hide glossary Glossary. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. National Library of Medicine [17] do not mention whether any patients underwent biopsy (Table 3). -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. what causes mucoid degeneration of acl. Download Citation | On Feb 1, 2023, O.R. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. Careers. 2020 Jun 2. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Mucoid degeneration of the anterior cruciate ligament: a case report. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. 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. Individuals with mucoid degeneration of the ACL were excluded. 2018. http://journals.sagepub.com/doi/10.1177/2325967118786930, Pandey V, Suman C, Sharma S, Rao SP, Kiran Acharya K, Sambaji C (2014) Mucoid degeneration of the anterior cruciate ligament: management and outcome. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782). government site. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. -Evaluated and planned treatment protocol in accordance with physician. 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. Knee Surg Sports Traumatol Arthrosc. The clinical presentation is one of posterior pain with limited flexion. It is a chronic degenerative change of a bulky ACL that may lead to notch . On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. CAS Ventura et al. Mucoid change or mucoid degeneration refers to the irreversible tissue degeneration due to the accumulation of mucin within the fibers of tendons, ligaments, and fibrocartilage. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. Bethesda, MD 20894, Web Policies Postoperative symptomatic instability was not common in eight studies, but was observed in 48% of patients in the study of Lintz et al., with two patients having a delayed ACL reconstruction. Methods: The minimum follow-up was 3 years. Reeducation. 2011 Mar;25(3):262-5. . Careers. What is myxoid degeneration treatment? Knee Surg Sports Traumatol Arthrosc. It results in postoperative laxity, but rarely in frank instability. The https:// ensures that you are connecting to the 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. The appearance can mimic acute or chronic interstitial partial tears of the ACL. Four studies reported only postoperative scores, which were comparable to those in other studies. An official website of the United States government. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Skeletal Radiol. There was more than 20% loss to follow up in the study of Kim et al., while the three prospective studies had no loss to follow up [13, 14, 18]. Bookshelf Knee Surg Sports Traumatol Arthrosc. 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. Postoperative pain relief ranged from 53.8 to 95%. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Anterior knee pain is the more common complaint. The clinical presentation is one of posterior pain with limited flexion. Method. 2012;4 (2): 167-70. The mean MINORS score was 9.5 out of 16 (412). Arthroscopic findings. sharing sensitive information, make sure youre on a federal Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. Epub 2018 Apr 21. 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). Clipboard, Search History, and several other advanced features are temporarily unavailable. Epub 2011 Feb 18. 2004;182 (5): 1283-7. Mucoid degeneration of the ACL is a rare cause of knee pain.1-8) This lesion of the ACL was first reported by Kumar et al.3) in 1999. Treatment options include non-operative management, arthroscopic debridement with a biceps tenotomy or tenodesis, complete or partial repair, patch augmentation, superior capsular reconstruction, muscle/tendon transfer and reverse total shoulder arthroplasty. FOIA The site is secure. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. The https:// ensures that you are connecting to the Mucoid degeneration of the anterior cruciate ligament. Questions just answered: mucoid degeneration of acl physiotherapy. 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.

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