mucoid degeneration of acl physiotherapy

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. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. 2. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. Ligaments are very tough, fibrous tissue structures. [17] do not mention whether any patients underwent biopsy (Table 3). Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Epub 2008 Dec 17. Chudasama CH, Chudasama VC, Prabhakar MM. Bilateral Symptomatic Mucoid Degeneration of the Anterior - Hindawi (A) Bulging of, Fig. Knee Surg & Relat Res 33, 26 (2021). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. J Sports Med Phys Fitness 48(4):483487, PubMed [Diagnosis and treatment of anterior cruciate ligament cysts]. official website and that any information you provide is encrypted https://doi.org/10.1007/s00167-012-1991-9, McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Would you like email updates of new search results? Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. A long duration of non-specific knee pain in a patient should be evaluated with MRI. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Unauthorized use of these marks is strictly prohibited. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. sharing sensitive information, make sure youre on a federal PubMed The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. It results in postoperative laxity, but rarely in frank instability. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. Skeletal Radiology. Indian J Orthop. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Clin Orthop Surg. mucoid degeneration of acl - Best Orthopedic doctor in Jaipur The clinical presentation is one of posterior pain with limited flexion. This is basically an MRI diagnosis of expansion and increased signal of an intact ACL in a person with knee pain which is worse on knee flexion/bending. in 1999 [1]. Postoperative clinical laxity was common, however, symptomatic instability was not. Mucoid degeneration of the anterior cruciate ligament bling. The origin of MDACL may be degenerative or traumatic. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. 2011 Jun;25(6):650-2. 2004;182(5):12831287. as very low (04 points), low (58 points), good (912 points) or excellent (1316 points) [12]. Pain was posterior in 23 knees (80%). Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. The .gov means its official. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. eCollection 2022 May-Jun. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. mucoid degeneration of acl mri. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. . 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Arthroscopic examination analyzed the ACL aspect and its associated lesions (meniscus, cartilage). All rights reserved. Conclusion: This was lowest in the study of Cha et al. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. In six of the nine studies [6, 14, 16,17,18], arthroscopic debridement of the ACL was associated with simultaneous partial meniscectomy; this ranged from 13% in the study of Morice et al. A total of 313 knees in 292 patients were included in the nine studies. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. HHS Vulnerability Disclosure, Help It can cause pain and to a meniscal tear. The patient presented with extension block of the knee. 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. Online ahead of print. The extracted data were heterogeneous in terms of outcome assessment. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. . Read More Created for people with ongoing healthcare needs but benefits everyone. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Arthroscopic treatment of mucoid degeneration of the anterior cruciate Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. This ranged from 90 to 95% in all studies, except in the report by Kim et al., where only 53.8% of patients (57/106) had complete pain relief after surgery. 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. 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. J Chin Med Assoc. How is mucoid degeneration treated? - Sdnimik.bluejeanblues.net Unable to load your collection due to an error, Unable to load your delegates due to an error. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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. https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Introduction: Assessment of Anterior Cruciate Ligament (ACL) Degeneratio Mucosa Treatment Imaging: Plain radiographs Epub 2021 Mar 8. Increased posterior slope and coronal inclination of the tibial joint The mean MINORS score was 9.5 (range 412). Chudasama et al. W B Saunders Co. (2005) ISBN:0721602703. Symptomatic ACL mucoid degeneration in middle-age athletes. 2023 BioMed Central Ltd unless otherwise stated. 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]. The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. Clipboard, Search History, and several other advanced features are temporarily unavailable. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. 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. However, the authors did not report whether there were any other patients with symptomatic instability. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. This systematic review has some limitations. https://doi.org/10.4103/0019-5413.101037, Srivastava A, Pateliya S, Singh H, Aggarwal S, Srivastava S (2016) Mucoid degeneration of anterior cruciate ligament management and functional outcome of 18 cases. 2012;4 (2): 167-70. This is a rare pathological condition, in which, there is increased signal from within the ligament. This site needs JavaScript to work properly. volume33, Articlenumber:26 (2021) Before 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. ANZ J Surg 73(9):712716. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. Deep Seated Pain at Back of Knee with Bending | Dr HC Chang AJR Am J Roentgenol. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. -. 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.). (61years), which was the largest study and represented more than one third of the total patients included in this review. Ventura et al. Epub 2011 Feb 18. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Discussion: 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. The mean age of patients ranged from 31 to 78years. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. The .gov means its official. (Table 3). 2011 Aug 1;19(8):1326-33. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. Treatment for MDACL usually starts non-surgically with anti-inflammatory drugs and physiotherapy. official website and that any information you provide is encrypted Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. Cho SD, Youm YS, Lee CC et-al. For non-comparative studies, this consists of eight questions. Loreto v. Kijakazi, 1:22-CV-1404-JDG | Casetext Search + Citator Bookshelf The pathogenesis remains controversial. Twenty-eight knees (97%) showed soft and/or delayed stops on postoperative Lachman testing. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 2007;15 (1): 73-86. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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). https://doi.org/10.1016/j.jclinepi.2009.06.005. Check for errors and try again. MM and A performed the literature search, and data analysis. All nine studies were case series; six were retrospective and three were prospective studies. There was an improvement in postoperative range of motion and outcome scores (Lysholm and International Knee Documentation Committee scores and the Knee Injury and Osteoarthritis Outcome Score). Terms and Conditions, Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Pandey, Vivek et al. By using this website, you agree to our Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. What are the treatment options for anterior cruciate ligament mucoid Clinical significance of T2*-weighted gradient-echo MRI to monitor Arthroscopy. 1992;159(2):35760. ACL Mucoid Degeneration in Knee - Diagnosis & Treatment | Dr. Hemendra An official website of the United States government. Seventeen females (67%) and eight males (33%) were included in the final analysis. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flowchart illustrating the selections of trials included in the systematic review. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . https://doi.org/10.4103/0019-5413.128765, Article 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. The aetiology of MDACL is not clearly understood. JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment. Its signal is increased on all sequences. Joshita Poojary - Sports Physical Therapist - Padmanabhan's - Linkedin PMC The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Four studies reported only postoperative scores, which were comparable to those in other studies. -, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. MRI - Interstitial ACL tear With Mild knee joint effusion ,No evidence of discontinuation of fibre Can Interstitial ACL tear heal without surgery Asked for Male, 22 Years 78 Views v Dr. Abhishek Kaushik Joint Replacement Surgeon | Delhi 1/1 people found this helpful Hi. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. Bergin et al. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. J Knee Surg. The extracted data were assessed for meta-analysis. Preoperative assessment included a questionnaire, clinical examination (Lachman and pivot shift tests), MRI and standard radiography. Introduction to Arthroscopic Debridement The rate of simultaneous meniscectomy ranged from 13 to 44%. The site is secure. in 1999 [ 1 ]. Knee Surg Sports Traumatol Arthrosc. Skeletal Radiol. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . Physiotherapy. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. 2010 Jun;96(4):400-6. doi: 10.1016/j.otsr.2010.02.008. reported on the co-existence of mucoid degeneration and ganglia of the ACL. 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. -Evaluated and planned treatment protocol in accordance with physician. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. Resnick D, Kransdorf MJ. There was strong association with chondral lesions and meniscal tears. 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]. 2009. The visual analogue scale score, the International Knee Documentation Committee score, and the Tegner Lysholm Knee Score were collected preoperatively, postoperatively, and during the follow-up period. Reeducation. 8600 Rockville Pike After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. sharing sensitive information, make sure youre on a federal In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. 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. No treatment is usually required. This did not appear to affect the postoperative rate of clinically detectable laxity, which was comparable to that in other studies. Anterior cruciate ligament mucoid degeneration - Radiopaedia Management of mucoid degeneration of the anterior cruciate ligament: a Unable to load your collection due to an error, Unable to load your delegates due to an error. KoreaMed Synapse There was strong association between degenerative changes and MDACL (82% having chondral and 69% meniscal lesions), which might suggest that MDACL is a degenerative process.