Conclusions. Bergin et al. 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]. Postoperative pain relief ranged from 53.8 to 95%. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. Federal government websites often end in .gov or .mil. Cite this article. 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. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Epub 2018 Aug 22. HHS Vulnerability Disclosure, Help 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. 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. An official website of the United States government. Bethesda, MD 20894, Web Policies MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Epub 2010 May 8. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Mucoid degeneration of the anterior cruciate ligament. 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. 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. (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). A posterior approach will allow for the detection of changes by probing the ligament and mucoid material can be expressed. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. Arch Orthop Trauma Surg. -. They respond well to a judicious arthroscopic release of the ACL with notchplasty. It results in postoperative laxity, but rarely in frank instability. 2. Epub 2011 Feb 18. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Discussion: 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. 2011 Jun;25(6):650-2. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Knee Surg Sports Traumatol Arthrosc. 287 (3): 912-921. All rights reserved. Accessibility Hide glossary Glossary. This may support the theory that it is a degenerative process. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. Six studies reported using the pivot shift test; unsurprisingly, Lintz et al. FOIA The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. What you feel (symptoms) You feel heaviness in knee joint. The mean follow up ranged from 13 to 72months. The .gov means its official. Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. The .gov means its official. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. This site needs JavaScript to work properly. Knee Surgery & Related Research what causes mucoid degeneration of acl. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. 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. Springer Nature. Physiotherapy. Before Categories were determined in accordance with the study of Ekhtiari et al. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Unauthorized use of these marks is strictly prohibited. Twelve partial and 17 total resections were performed. Unable to process the form. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. 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]. FOIA Indian J Orthop. 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. Arthroscopy. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. 2011;19(3):408411. Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. . Privacy Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). TS designed the project, literature search and wrote the manuscript. 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). There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). The .gov means its official. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms -, 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. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. J Arthrosc Joint Surg 3(1):2833. 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. Symptomatic ACL mucoid degeneration in middle-age athletes. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. 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. . However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. (10%) and highest in the study of Ventura et al. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. NCI CPTC Antibody Characterization Program. 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. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. On clinical examination, the active range of motion showed a flexion deficit. Mucoid degeneration of the anterior cruciate ligament: a case report. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. Clin Orthop Surg 10(3):307314. However, MDACL is asymptomatic in most patients. Preoperative and postoperative results of eleven patient were compared. Introduction: 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. The clinical presentation is one of posterior pain with limited flexion. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. 1. Epub 2011 Feb 18. Seventeen females (67%) and eight males (33%) were included in the final analysis. Bookshelf Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Epub 2011 Feb 18. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. J Knee Surg. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. The reported restriction of range of movement was flexion deficit in four studies [3, 13, 15, 17], extension deficit in one study [14] and combined flexion and extension deficit in four studies [6, 16, 18, 19] (Table4). 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. Arthroscopy. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. Epub 2013 Aug 27. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management.