https://doi.org/10.1177/03635465010290051301, Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is commonly treated with arthroscopic debridement of the ACL. Usually there is no history of any significant trauma. 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. All rights reserved. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Amyn M. Rajani. Hence, study objectives included determining the role and effects of debulking MD-ACL in a patient undergoing UKA as compared with those who do not undergo debulking, by clinical and functional analysis at 2years post-operatively. 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. During the physical exam, your doctor will check your knee for swelling and tenderness comparing your injured knee to your uninjured knee. Mayo Clinic is a not-for-profit organization. Treatment: For symptomatic knees surgical debulking /debridement in which thickened part of the ACL is shaved off, is the treatment of choice. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Doctors and physical therapists will perform tests to gauge your knee's stability, strength, function and readiness to return to sports activities at various intervals during your rehabilitation. -Evaluated and planned treatment protocol in accordance with physician. This study aims to compare functional and clinical outcomes of debulking the mucoid ACL in patients undergoing mobile-bearing unicompartmental knee arthroplasty (UKA). UKA by itself improves the functional and clinical outcome of patients with medial compartment osteoarthritis. fibroid degeneration degeneration of a leiomyoma with subsequent fibrosis. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting, More than one ligament or the fibrous cartilage in your knee also is injured, The injury is causing your knee to buckle during everyday activities. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar etal. b Immediate post-operative radiograph showing no posterior translation of femur compared with pre-operative radiograph. The Infona portal uses cookies, i.e. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. Shelbourne Knee Center recommends activity modification and rest, medications, injections and/or physical therapy as the initial treatment(s). 21 yrs old Male asked about Mucoid degeneration of ACL, 2 doctors answered this and 92 people found it useful. https://doi.org/10.3109/17453679209154722, Gibson PH, Goodfellow JW (1986) Stress radiography in degenerative arthritis of the knee. 2023 BioMed Central Ltd unless otherwise stated. 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 . Very minor tears (sprains) may heal with non-surgical treatments and regenerative medicine therapy. . This is a 79-year old woman with recently found asymptomatic left hydronephrosis. Intraosseous ganglion 6. Reeducation. The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case series. Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor. K Kunal: Substantial contributions to the conception, drafting the work, interpretation of data for the 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. By using this website, you agree to our 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. Anterior cruciate ligament injury. A case of mucoid degeneration of the anterior cruciate ligament (ACL) is reported based on specific imaging features on MRI. All authors contributed to the study conception and design. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Skeletal Radiol 2001 Jun; 30(6): 312-5. The demographic data of the study population is presented in Table 1. https://link.springer.com/10.1007/s00590-021-03198-4. Results: Visual analogue scale and Lysholm scores improved compared with preoperative scores, along with strength (anterior drawer test and Lachman test). Flowchart representation of selection process of sample size, intervention process and outcome assessment. They cross each other to form an X with the anterior cruciate ligament in front and the posterior cruciate ligament in back. Advertising revenue supports our not-for-profit mission. How common is mucoid degeneration of the ACL? J Bone Jt Surg Br 93(4):4768. 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. 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). Friedberg RP. strings of text saved by a browser on the user's device. 3 Do-Dai DD, Youngberg RA, Lanchbury FD, et al: Intraligamentous ganglion cysts of the anterior cruciate ligament: MR findings with clinical and arthroscopic correlations. He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. Google Scholar, Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D (2011) Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Paterno MV, et al. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Anterior knee pain is the more common complaint. Intraosseous increased signal is present within the tibial spine deep to the posterior extent of the ACL insertion (arrowhead). They are frequently seen at joints and tendons of the wrist but are rare in the region of knee joint. on nine studies [8]. ), or their login data. Freedom from war and natural disaster. [21]. AskMayoExpert. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Am J Sports Med 29(5):600613. . Flag this answer. Treatment Notes prior to January 29, 2019 . This was a prospective, cohort, multicentric study conducted in five centres. Mucoid degeneration of the anterior cruciate ligament, International Knee Documentation Committee, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Mumbai, Maharashtra, India. 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. When a cruciate ligament ganglion is discovered incidentally, no intervention is necessary. An interesting feature of cruciate ganglia, which has not been widely reported, is their tendency to extend into adjacent intra-articular spaces and osseous structures. 4 McIntyre J, Moelleken S, Tirman P: Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears . As this improvement might not be entirely due to PRP, high-end comparative studies are needed to confirm its efficacy. It can be secondary to trauma, or simply degeneration caused by meniscal injury, osteoarthritis or chondral damage [2]. 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 . On inter-group comparison, the group in which debulking was done had better mean KSS and mean IKDC score at 2years of follow-up (p<0.05). Terms and Conditions, With the advent of the mobile-bearing UKA system, the predilection towards this surgery is on an upward trend. 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. Treatment: For symptomatic knees surgical debulking /debridement in which thickened part of the ACL is shaved . 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). Anyone else have this and how was it treated if at all? However, a predetermined list of criteria has been compiled over the years based on findings in published reports within which a patient needs to fall so as to be eligible to undergo a UKA. The time it takes to recover is approximately 3 months. 1998 Oct;53(10):771-3. The etiology of cruciate ligament ganglion cysts is uncertain. https://doi.org/10.4055/cios.2018.10.3.307. S Banerjee: Substantial contributions to the conception, drafting the work interpretation of data for the 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. When considering a UKA in such a patient, a plethora of dilemmas may arise in the mind of an orthopaedic surgeon vis a vis preserving the MD-ACL at the cost of functional limitation, or debulking it and predisposing the UKA to failure owing to instability. Contact us. 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. [22]. Conclusion: PRP can be used to improve the healing and strength ofa weakened ACL after partial debridement, but further research is needed to demonstrate its efficacy. Without adequate and timely treatment, . 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.
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