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Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Knee 27(5):13321342. You may also wear a brace to stabilize your knee and use crutches for a while to avoid putting weight on your knee. It is postulated that mucoid degeneration may be a predisposing factor to the formation of ACL ganglion cysts . Methods From January 2012 to August 2013, 32 knees (24 females and 8 males with left knee of 14 and 18 of right) were diagnosed with mucoid degeneration of the ACL and underwent arthroscopic treatment, all of whom with a mean age of 58.817.97 years (42-74 years). It is a very rare cause of knee pain and can be diagnosed preoperatively on MRI. Platelet-rich plasma (PRP) is known to influence musculoskeletal healing through multiple growth factors. 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 Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. 2014;42:1567. Mucoid degeneration and ganglion cyst are two distinct non-traumatic lesions of the anterior cruciate ligament (ACL) that most commonly occur discretely but occasionally coexist. Love. 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. Am J Roentgenol 182(5):12831287. Skeletal Radiol 2001 Jun; 30(6): 312-5. All authors read and approved the final manuscript. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Mucoid degeneration of ACL is a disease affecting ACL in which mucoid like substance (glycosaminoglycans) gets interspersed within the substance of ACL and as a result ACL gets thickened. 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). It's a site that collects all the most frequently asked questions and answers, so you don't have to spend hours on searching anywhere else. By using this website, you agree to our 2). b Immediate post-operative radiograph showing no posterior translation of femur compared with pre-operative radiograph. 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. Instrumental treatment. Let others know if this answer was helpful Mucoid degeneration of the anterior cruciate ligament (ACL) is a common pathology but is often unknown and underdiagnosed. It can trap and damage the menisci in the knee and can also lead to early osteoarthritis. Treatment of Atherosclerotic Disease of the Femoral Artery: Randomized Controlled Trials and Meta-Analyses. Google Scholar, Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A (2021) Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. 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. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. . Secondly, all the patients underwent the surgery and postoperative rehabilitation based on a standardized protocol which may limit the reproducibility of results if not adhered to. 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. Although arthroscopic resection of the degenerated ACL is the treatment of choice following the failure of conservative management, the extent of the excision and subsequent ACL reconstruction for . Here are the search results of the thread mucoid degeneration of acl treatment from Bing. A coordinator will follow up to see if Mayo Clinic is right for you. Anterior cruciate ganglion cysts are probably more prevalent than stated in the literature. The portal can access those files and use them to remember the user's data, such as their chosen settings (screen view, interface language, etc. It results in postoperative laxity, but rarely in frank instability. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. 1998 Oct;53(10):771-3. In vivo elongation of the anterior cruciate ligament and posterior cruciate ligament during knee flexion. PubMed Int J Curr Res Acad Rev 4(11):1824. During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon tissue similar to a ligament that connects muscle to bone. Despite integrity and status of cruciates being paramount in a UKA, no study has evaluated the effect of debulking MD-ACL in this procedure. 3). There's no set time frame for athletes to return to play. 4th ed. The second most common complaint in patients with MD-ACL, namely rest pain, also showed statistically significant reduction at 2years follow-up in patients who underwent debulking as compared with their counterparts, as measured by VAS score. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Background: The anterior cruciate ligament (ACL) is the most commonly operated ligament of the knee. Knee 18(3):168171. A: ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. In terms of treatment, doctors mostly recommend an arthroscopy, a minimally invasive surgical procedure which examines and sometimes . Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. The rest of the surgery remained the same and all patients underwent mobile-bearing Oxford UKA. Home | About | Contact | Copyright | Report Content | Privacy | Cookie Policy | Terms & Conditions | Sitemap. Pre-operatively, patients were examined and clinicoradiologically confirmed for MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee. strings of text saved by a browser on the user's device. On table, the extent of impingement caused by the mucoid degeneration was gauged using an arthroscopy hook. This content does not have an Arabic version. An anterior cruciate ligament (ACL) mucoid degeneration, along with tears and anterior cruciate ligament ganglion cysts, is a relatively common cause of incr. In patients undergoing UKA and diagnosed with mucoid degeneration of the ACL, controlled debulking of the ACL provides better functional outcomes as compared with non-debulking of the mucoid ACL. The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. Shelbourne Knee Center recommends activity modification and rest, medications, injections and/or physical therapy as the initial treatment(s). Answered . All Rights Reserved. Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament Clinics in Orthopedic Surgery Vol. Mucoid degeneration of ACl is a rare pathological process involving knee joint. J Bone Jt Surg Ser B 81(2):304305. After surgery patient is allowed to walk from the next day. All the demographic and biostatistical data was compiled and computed on the SPSS-24 software. https://doi.org/10.1177/03635465010290051301, Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. . 1 Brown MF, Dandy DJ: Intra-articular ganglia in the knee. If present in a patient undergoing unicompartmental knee arthroplasty, it can deteriorate the final outcome. It provides objective end points for open debulking of mucoid ACL in these patients and, being a multicentric study, it entails external validity of this procedure in a diverse population. 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. At minimum 2years post-operatively, patients were called for a follow-up, and they were assessed clinically for ROM and stability by a blinded clinician not involved in the clinical care of the patients. It can cause pain and to a meniscal tear. This study aims to compare functional and clinical outcomes of debulking the mucoid ACL in patients undergoing mobile-bearing unicompartmental knee . These cysts have a variable MR appearance and are not always confined to the substance of the ligament. Pre-operative and follow-up lateral radiographs of the patients who underwent debulking were analysed by a blinded radiologist and no posterior translation of the femur was noted, thereby confirming no instability caused by the debulking (Fig. T2-weighted sagittal view demonstrates localized fluid signal within the ACL (arrows). Clin Orthop Relat Res 248:1314, Hotchen AJ, Melton JTK (2018) Radiofrequency ablation for mucoid degeneration of the anterior cruciate ligament. Common wrist ganglions include: dorsal wrist ganglion volar wrist ganglion volar retinaculum ganglion extensor retinaculum ganglion occult ganglion intraosseous ganglion mucous cyst In a 2007 study of patients in Glasgow whose foot lumps were removed surgically, 39 of 101 cases were ganglion cysts. 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. 1st ed. [] found the incidence of mucoid degeneration in their study population to be 1.0%.Most of their reported cases were incidental findings without contributory symptoms. https://doi.org/10.4055/cios.2018.10.3.307. Dietary management and various treatments Scanning and diagnostic . This is a 79-year old woman with recently found asymptomatic left hydronephrosis. No writing assistance was utilized in the production of this manuscript. 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 . The results found improved functional scores and pain scores compared with preoperative levels. 10, No. Treatment: For symptomatic knees surgical debulking /debridement in which thickened part of the ACL is shaved . I saw this news report on CNN politics and somehow I find Mr. Trumps theory on human energy really interesting, so he Its Christmas day, and everything should have gone just in its right way, except it doesnt. We describe Arthroscopic near total debridement of mucoid degenerated ACL in . What is mucoid degeneration of the meniscus? Despite maximising the factors involved between the two groups, as the sample size collection was done during two separate time periods and consecutive sampling was done instead of randomisation, there is a possibility of sampling bias. 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. Anterior cruciate ligament (ACL) injuries. J Sports Med Phys Fit 48(4):483487, CAS Google Scholar, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Physiotherapy and yoga based exercises will help you. The demographic distribution of study population with respect to the mean age, gender distribution and the side affected was similar to the recent studies done on the MD-ACL as a standalone entity [2, 3, 5, 8]. Others may make an appointment with their family doctors. These ganglia consist of myxoid material. 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 . Contact us. However, all of these debridements were done under arthroscopy, whereas the surgeons in this study progressively debulked the ACL by open method using a 15-number blade, under direct vision. 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. [6] and Lintz etal. These patients who underwent UKA with debulking of MD-ACL were included in group B (nb=226). Advertising revenue supports our not-for-profit mission. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. 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. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. With the advent of the mobile-bearing UKA system, the predilection towards this surgery is on an upward trend. The pathogenesis of mucoid degeneration is unclear, but injury, ganglion cysts, and degenerative process have been implicated as the most likely etiologic factors in the production of this change. They were segregated into two groups matched for all demographic and pre-operative values: group A did not undergo debulking; group B underwent open debulking by a 15-number blade prior to UKA. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity with disputed theories of origin [1,2,3,4]. However, the terminal ROM achieved after debulking MD-ACL was significantly better (p<0.05) at 2years of follow-up as compared with the group that did not undergo debulking. Connect with thousands of patients and caregivers for support, practical information, and answers. 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. 21 yrs old Male asked about Mucoid degeneration of ACL, 2 doctors answered this and 92 people found it useful. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008 (5).