mucoid degeneration of acl physiotherapy mucoid degeneration of acl physiotherapy

volume33, Articlenumber:26 (2021) To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2018;4(4):875-80. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. There is no consensus on treatment and evidence is scarce. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate The need for simultaneous or delayed ACL reconstruction should be discussed with patients in case total resection of the ACL is to be performed, particularly in young active patients. An official website of the United States government. Only nine studies met our inclusion criteria and they were all case series. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). https://doi.org/10.1016/j.jclinepi.2009.06.005. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Please enable it to take advantage of the complete set of features! Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. [16]. 5. Skeletal Radiology. (100%). -, Fealy S, Kenter K, Dines JS, Warren RF. What causes mucoid degeneration of ACL? Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. eCollection 2021. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. 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 Symptomatic ACL mucoid degeneration in middle-age athletes The retrospective study by Kim et al. Generally, we know little about this condition. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Knee Surgery & Related Research Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Mucoid degeneration of the anterior cruciate ligament: can platelet ACL tears don't heal as such. Average patient age was 49 (22 to 68) years. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. Unable to load your collection due to an error, Unable to load your delegates due to an error. FOIA Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. The extracted data were assessed for meta-analysis. Epub 2008 Dec 17. Preoperative and postoperative results of eleven patient were compared. Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings. The site is secure. Careers. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. 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. Arthroscopic findings. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. J Bone Joint Surg Br. Categories were determined in accordance with the study of Ekhtiari et al. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. 2004;182(5):12837. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Symptomatic ACL mucoid degeneration in middle-age athletes. Unauthorized use of these marks is strictly prohibited. Tamer Sweed. 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. Anterior cruciate ligament mucoid degeneration: selecting the best Four studies reported only postoperative scores, which were comparable to those in other studies. This systematic review has some limitations. Anterior knee pain is the more common complaint. eCollection 2013. Mucoid degeneration of the anterior cruciate ligament. Mucoid cystic degeneration of the cruciate ligament. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. Clipboard, Search History, and several other advanced features are temporarily unavailable. Arthroscopy. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. 2011. Average postoperative International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were 71.2 (42.5 to 92.0) and 78.2 (26.4 to 99). Cite this article. Methods: -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. Bone and joint imaging. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. No treatment is usually required. What is Anterior Cruciate Ligament Mucoid Degeneration? You can read more if you want. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. The mean follow up ranged from 13 to 72months. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. official website and that any information you provide is encrypted National Library of Medicine government site. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. PubMed Magnetic Resonance Imaging is the most useful tool for differentiating mucoid degeneration of the ACL from an intraligamentous ganglion or other lesions in the knee joint and if this disease is considered preoperatively, it can be diagnosed easily based on characteristic findings. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. HHS Vulnerability Disclosure, Help It results in postoperative laxity, but rarely in frank instability. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). 6. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. The rate of simultaneous meniscectomy ranged from 13 to 44%. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. 1. This may support the theory that it is a degenerative process. The mean age at the time of surgery was 57 years (range, 31 to 78 years). Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. 1173185. Before Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. Mucoid degeneration of the anterior cruciate ligament. Glossary of terms for musculoskeletal radiology. Disclaimer. Terms and Conditions, The author(s) read and approved the final manuscript. The clinical presentation is one of posterior pain with limited flexion. MDACL is differentiated from synovial cysts of the anterior cruciate ligament (ACL) where, in MDACL, mucoid tissue intermingles within ACL fibres and is not contained within a cyst [3]. Bethesda, MD 20894, Web Policies Mucoid degeneration of the anterior cruciate ligament: a case report. . Arthroscopy. https://doi.org/10.1302/0301-620X.81B2.0810304, Article TS designed the project, literature search and wrote the manuscript. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. Its signal is increased on all sequences. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment International Journal of Orthopaedics. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. MeSH Fig. There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. 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]. 2008;24(6):642649. 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. The purpose of this study was to investigate the outcome of management of MDACL by performing a systematic review of methods of treatment that have been reported. AJR Am J Roentgenol. It has recently been postulated that mucoid degeneration of the ACL is related to the medial knee compartment joint space loss in patients with osteoarthritis or in the OA risk group 6. The clinical presentation is one of posterior pain with limited flexion. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT - YouTube Epub 2018 Jan 2. 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]. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. in 1999 [1]. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Please enable it to take advantage of the complete set of features! Keywords: However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Arthroscopic treatment of mucoid degeneration of the anterior cruciate ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and . Background: 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. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Postoperative pain relief ranged from 53.8 to 95%. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. 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. Skeletal Radiol. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the National Library of Medicine 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). 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. In most cases Physiopedia articles are a secondary source and so should not be used as references. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons. Postoperative clinical laxity was common, however, symptomatic instability was not. Part of Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. FOIA 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. 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 patellar ligament in athletes. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. AJR Am J Roentgenol. 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 mucoidlike substance, [1,2 . Disclaimer. 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. Rehabilitation, speech therapy, crenotherapy. 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. The pathogenesis remains controversial. Besides, the patient may also have trouble in moving. J Orthop. have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. This study concerns complete ACL resec Instrumental treatment. Online ahead of print. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Indian J Orthop 48(2):197202. Knee Surg Sports Traumatol Arthrosc. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Knee Surg Sports Traumatol Arthrosc. What you feel (symptoms) You feel heaviness in knee joint. However, the authors did not report whether there were any other patients with symptomatic instability. Bookshelf If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Results: proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Introduction: Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Physical Therapy. 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.). Mucoid Degeneration of the Anterior Cruciate Ligament - ResearchGate ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. Arthroscopy. Instrumental treatment. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. Anterior cruciate ligament mucoid degeneration - Radiopaedia These appearances must be differentiated from mucoid degeneration of the intact ACL. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. 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. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. 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. Advanced MR imaging of the cruciate ligaments. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity that has been found in patients with pain and limited range of motion of the knee in association with a bulky ACL shown on magnetic resonance imaging (MRI). Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). The .gov means its official. Physiotherapy. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. Mucoid degeneration of the anterior cruciate ligament. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Pan African Medical Journal. 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. in 1999 [ 1 ]. 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. The appearance can mimic acute or chronic interstitial partial tears of the ACL. The extracted data were heterogeneous in terms of outcome assessment. Hide glossary Glossary. Orthopaedics & Traumatology: Surgery & Research. https://doi.org/10.4103/0019-5413.128765, Article Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. Score: 4.7/5 (45 votes) . Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Cookies policy. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . KoreaMed Synapse J Chin Med Assoc. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. Epub 2018 Jun 13. (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). 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. Mucoid degeneration of ACL. Anterior Cruciate Ligament (ACL) Mucoid Degeneration - Physiopedia 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. Would you like email updates of new search results? official website and that any information you provide is encrypted J Knee Surg. Imaging: Plain radiographs 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. AJR Am J Roentgenol. (PDF) Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration GG and AM interpreted the results and reviewed the manuscript. Case report: Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms Read More Created for people with ongoing healthcare needs but benefits everyone. The origin of MDACL may be degenerative or traumatic. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Postoperative pain relief was reported in seven studies. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg.