All authors read and approved the final manuscript. A single copy of these materials may be reprinted for noncommercial personal use only. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The minimum follow-up was 3 years. A common sports injury whichusually happens over time from normal wear and tear ofmuscles and tendons. 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 . 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. (Table 2). What happens if you dont get surgery on a torn ACL? Another theory states that it is a consequence of herniation of a synovial pouch in the substance of the anterior cruciate ligament (ACL), and the subsequent synovial filling inside it; however, the major aetiology of MD-ACL still remains an enigma [4]. The ACL graft (arrow) is abnormally lax and demonstrates abnormally increased signal intensity, likely secondary to degeneration from chronic mechanical stress. Modalities such as icing, joint mobilization, and massage can provide short-term pain relief and reduce swelling. Score: 4.7/5 (45 votes) . Method. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. The lesion may look like an elongated cyst along the long axis of the ACL, or as an enlarged ACL. Do you ever feel that your knee is unstable or unable to support your weight? 2015;23:283. There's no set time frame for athletes to return to play. -Delivered Pre-rehab care for breast cancer and thoracic cancer cases. 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 median age of the affected population is estimated to be 51years [5]. fibroid degeneration degeneration of a leiomyoma with subsequent fibrosis. Friedberg RP. Without adequate and timely treatment, . J Sports Med Phys Fit 48(4):483487, CAS If your activities do not involve making pivoting movements on the knee, physical therapy rehabilitation may be all you need. 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. M.P. 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. If present in a patient undergoing unicompartmental knee arthroplasty, it can deteriorate the final outcome. Finally, the patients who underwent debulking had a better mean subjective patient satisfaction (9.830.37 versus 8.680.71) at the final follow-up at 2years (p<0.05) (Table 2). 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. The ligament can also tear due to work injuries or automobile accidents. It can be misdiagnosed a partial ACL tear. [5]. The anterior cruciate ligament (ACL) is an important ligament in the knee. At arthroscopy, the ACL appeared homogenous, bulbous, and hypertrophied in all patients. -Evaluated and planned treatment protocol in accordance with physician. 6 Antonacci VP, Foster T, Fenlon H, Harper K, Eustace S: Technical report: CT-guided aspiration of anterior cruciate ligament ganglion cysts. 58th ed. Injury prevention. 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. Reeducation. Scribd adalah situs bacaan dan penerbitan sosial terbesar di dunia. Mucoid degeneration of anterior cruciate ligament (ACL) 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. By continuing to browse this site, you accept our, International Journal of Endocrine Oncology, International Journal of Hematologic Oncology, Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C, Mucoid metaplastic-degeneration of anterior cruciate ligament, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR, Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation, Makino A, Pascual-Garrido C, Roln A, Isola M, Muscolo DL, Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK, Mucoid cystic degeneration of the cruciate ligament, Mucoid degeneration of the anterior cruciate ligament, Arthroscopic management of mucoid degeneration of anterior cruciate ligament, Pandey V, Suman C, Sharma S, Rao S, Kiran Acharya K, Sambaji C, Mucoid degeneration of the anterior cruciate ligament: management and outcome, Mucoid degeneration of the anterior cruciate ligament: a case report and review of literature, 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, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J, Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament, Kim T-H, Lee D-H, Lee S-H, Kim J-M, Kim C-W, Bin S-I, Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament, Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA, Platelet-rich plasma: from basic science to clinical applications, Southworth T, Naveen N, Tauro T, Leong N, Cole B, The use of platelet-rich plasma in symptomatic knee osteoarthritis, Vogrin M, Rupreht M, Crnjac A, Dinevski D, Krajnc Z, Renik G, The effect of platelet-derived growth factors on knee stability after anterior cruciate ligament reconstruction: a prospective randomized clinical study, Partial anterior cruciate ligament ruptures: advantages by intraligament autologous conditioned plasma injection and healing response technique midterm outcome evaluation, Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears, Rating systems in the evaluation of knee ligament injuries, Hensen JJ, Coerkamp EG, Bloem JL, Schepper AMD, Association of mucoid degeneration of anterior cruciate ligament with knee meniscal and cartilage damage, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P, Anterior cruciate ligament mucoid degeneration: selecting the best treatment option, Zicaro JP, Yacuzzi C, Garcia-Mansilla I, Costa-Paz M, Nonsurgical treatment of partial ACL tears: intraarticular injection of platelet-rich plasma did not change the progression rate to knee instability, Seijas R, Ares O, Cusc X, lvarez P, Steinbacher G, Cugat R, Partial anterior cruciate ligament tears treated with intraligamentary plasma rich in growth factors, Long-term outcomes of primary repair of the anterior cruciate ligament combined with biologic healing augmentation to treat incomplete tears, McRobb J, Kamil KH, Ahmed I, Dhaif F, Metcalfe A, Influence of platelet-rich plasma (PRP) analogues on healing and clinical outcomes following anterior cruciate ligament (ACL) reconstructive surgery: a systematic review. With the advent of the mobile-bearing UKA system, the predilection towards this surgery is on an upward trend. Extraligamentous extension into the joint and intercondylar notch produces a higher incidence of mechanical symptoms (7a). The authors declare that they have no competing interests. Ellman MB, et al. Correlation with operation methods in 200 knees. In these patients, when UKA is coupled with debulking of the MD-ACL with a predetermined end point, a significant improvement in the overall ROM, rest pain, functional outcome scores and subjective satisfaction of the patient can be achieved. 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. Some patient may also complain of pain with full knee extension. Close. 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. 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 . 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. (5a) Cystic form of ACL ganglion cyst. Methodology: Five patients who were diagnosed as a case . Clin Radiol. The cruciate ligaments control the back and forth motion of your knee. Rajani, A.M., Shah, U.A., Mittal, A.R.S. DeLee JC, et al. They are frequently seen at joints and tendons of the wrist but are rare in the region of knee joint. Part of This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. A: ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. Treatment: For symptomatic knees surgical debulking /debridement in which thickened part of the ACL is shaved . All rights reserved. Springer Nature. A proton density-weighted coronal view from the same patient as seen in (A) and (B) reveals intraosseous ganglia (arrows) communicating with the ACL ganglion cyst (short arrow). The most common cysts in the knee region are popliteal also called Bakers cysts. Have your symptoms been continuous or occasional? 1st ed. However, upon following-up with these patients, and gauging their clinical and functional parameters, complaints of rest pain and restriction of terminal flexion seemed to persist. These are found inside your knee joint. 2023 BioMed Central Ltd unless otherwise stated. Stability of the joint is not compromised on controlled debulking. Although a few studies such as the one by Lee etal. Home | About | Contact | Copyright | Report Content | Privacy | Cookie Policy | Terms & Conditions | Sitemap. Histopathological confirmation of mucoid degeneration was obtained in all 442 patients. Love. On longitudinal, intra-group comparison of the individual groups, it was noted that there was statistically significant (p<0.05) improvement in the ROM of patients who underwent debulking (Z-value: 13.047; p-value: 0.00) as well as no debulking group (Z-value: 9.990; p-value: 0.00) at 2years follow-up, compared with their individual pre-operative ROM. By a paramedian incision and mini-midvastus arthrotomy, the joint was exposed. Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor. Does your knee ever "lock" or feel blocked when you're trying to move it? A.R. Clin Orthop Surg 10(3):307314. Sagittal T1-weighted (1a) and fat-suppressed proton density-weighted (1b) images. 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 can be misdiagnosed a partial ACL tear. DOI: 10.1016/J.JAJS.2015.12.001 Corpus ID: 74774556; Mucoid degeneration of the anterior cruciate ligament: Partial arthroscopic debridement and outcomes @article{Khanna2016MucoidDO, title={Mucoid degeneration of the anterior cruciate ligament: Partial arthroscopic debridement and outcomes}, author={Gagan Khanna and Rajan Sharma and Aditya Bhardwaj and Harjot S. Gurdutta and Deepak Agrawal and . 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. Flag this answer. Feb 17, 2023 7:27 AM. Treatment of Atherosclerotic Disease of the Femoral Artery: Randomized Controlled Trials and Meta-Analyses. fatty degeneration deposit of fat globules in a tissue. 3, 2018 www.ecios.org Mucoid degeneration (MD . 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. Details on the top journals, universities, and authors on t. Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament Clinics in Orthopedic Surgery Vol. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity with disputed theories of origin [1,2,3,4]. 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. Anterior cruciate ganglion cysts are probably more prevalent than stated in the literature. 2001. In most cases, consideration of the clinical history, careful evaluation of the MR appearance, including the lack of ancillary findings of an ACL tear, and physical examination allow confident differentiation of a ganglion cyst from a cruciate ligament tear. 1998-2023 Mayo Foundation for Medical Education and Research. The most common cause of meniscus tears is age related degeneration. A coordinator will follow up to see if Mayo Clinic is right for you. (wikipedia.org)Rarely, intraosseous ganglion cysts occur, sometimes in . During the physical exam, your doctor will check your knee for swelling and tenderness comparing your injured knee to your uninjured knee. The severity of the ACL injury is graded from 1 to 3. The severity of the ACL injury is graded from 1 to 3. Mucoid degeneration of the anterior cruciate ligament: can platelet-rich plasma combined with reductionplasty provide better results? was the primary surgeon and was responsible for the conceptualization, methodology, supervision, writing review and editing. Journal of the American Academy of Orthopaedic Surgeons. Knee 27(5):13321342. 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. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Accessed Nov. 13, 2018. Being a multicentric study involving five different surgeons, surgeon factors could potentially affect surgical procedure and clinical outcome, despite a predetermined endpoint for the debulking. As this improvement might not be entirely due to PRP, high-end comparative studies are needed to confirm its efficacy. Is this likely to cause my knee pain or can it be the compressed lumbar nerve or both? I remember that Dr. Jain came out from his clinic to see my mother because my mother was not able walk a single step. Most older patients with meniscus tears can obtain relief from symptoms such as pain, swelling and decreased range of motion, and improve function, without surgery. Both groups showed overall improvement after surgery, however, patients who underwent debulking performed better at 2years follow-up in terms of Knee Society functional score, International Knee Documentation Committee scores, range of motion, rest pain and overall patient satisfaction (p<0.05) as compared with their counterparts. 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. In general, it takes as long as a year or more before athletes can safely return to play. J Orthop Traumatol. These appearances must be differentiated from mucoid degeneration of the intact ACL. Arthrosc Tech 7(5):e459e463. Connect with thousands of patients and caregivers for support, practical information, and answers. This study aims to compare functional and clinical outcomes of debulking the mucoid ACL in patients undergoing mobile-bearing unicompartmental knee arthroplasty (UKA). Autologous PRP, prepared by double spin protocol, was injected into the remaining ACL after partial debridement was done. Mentioning: 2 - We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). customer@scirp.org +86 18163351462(WhatsApp) This is done arthroscopically (arthroscopic/key hole surgery).