Notchplasty is an ancillary surgical procedure that consists of reshaping and widening of the intercondylar femoral notch, historically developed and performed with the aim to avoid ACL graft impingement and improve visualization of the lateral wall of the femoral notch during ACLR surgery. Mucoid degeneration of ACl is a rare pathological process involving knee joint. c 24.5months post-operative radiograph showing no posterior translation of femur compared with pre-operative and immediate post-operative radiograph. In: Current Medical Diagnosis & Treatment 2019. 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. However, in some patients, ACL ganglion cysts cause significant clinical symptoms. Provided by the Springer Nature SharedIt content-sharing initiative. The abnormal sliding within the knee also can hurt cartilage. Am J Roentgenol 182(5):12831287. But many studies have reported the weakening and laxity of ACL postoperatively and on follow-up. . Results: Visual analogue scale and Lysholm scores improved compared with preoperative scores, along with strength (anterior drawer test and Lachman test). While both the groups showed improvements in the functional scores post-surgery, which could be attributed to the UKA primarily, the finding that patients in whom debulking was done had better mean IKDC and mean KSS at 2years follow-up confirmed the study hypothesis that debulking improves the long-term outcome in patients with MD-ACL undergoing UKA. PubMed Central Freedom from war and natural disaster. Journal of the American Academy of Orthopaedic Surgeons. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Sun H, Gill TJ. Friends. Mucoid degeneration of the anterior cruciate ligament: can platelet-rich plasma combined with reductionplasty provide better results? Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. It results in postoperative laxity, but rarely in frank instability. Often the diagnosis can be made on the basis of the physical exam . Radiologic findings associated with mucoid degeneration of the anterior 1). A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). There have been only some reported cases of mucoid degeneration of the ACL in the English literature. 4 McIntyre J, Moelleken S, Tirman P: Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. An ACL sprain is when the ACL is overstretched (but not torn). J Sports Med Phys Fit 48(4):483487, CAS Usually there is no history of any significant trauma. was responsible for physiotherapy, writing review, editing and project administration. Accessed Nov. 13, 2018. anterior cruciate ligament mucoid degeneration; mucoid degeneration of the triangular . The median age of the affected population is estimated to be 51years [5]. 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. Rehabilitation, orthophony, crenotherapy. It can cause pain and to a meniscal tear. 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. Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor. A few studies have shown direct correlation between the presence of meniscus tear in patients with MD-ACL. Sports medicine & outpatient orthopedics. It can be misdiagnosed a partial ACL tear. [5] and Chudasama etal. Amyn M. Rajani. CAS In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. A: ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. The goal of rehabilitation is to reduce pain and swelling, restore your knee's full range of motion, and strengthen muscles. The cruciate ligaments control the back and forth motion of your knee. CIOS :: Clinics in Orthopedic Surgery The treatments all help with back and hip pain but I have a consistent back-of-knee pain that worsens with walking. Furthermore, the ancillary MR findings of an ACL tear, such as bone bruises and the MR anterior drawer sign, are absent. Reeducation. I remember that Dr. Jain came out from his clinic to see my mother because my mother was not able walk a single step. It can be misdiagnosed a partial ACL tear. Grade 1A laxity on Lachmans test (less than 5mm translation with a firm end-point) was noted in 27 knees (11.95%) intra-operatively in group B or those who underwent debulking (nb=226), whereas a firm endpoint with no translation was noted in all of the remaining 199 knees (88.05%). Methodology: Five patients who were diagnosed as a case of mucoid degeneration of the ACL based on MRI, over a period of 1 year (December 20182019), were included in the study. After a database search of 4,221 knee MRI examinations, Bergin et al. Rajani, A.M., Shah, U.A., Mittal, A.R.S. 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. Does mucoid degeneration of ACL require surgery? - TimesMojo At arthroscopy, the ACL appeared homogenous, bulbous, and hypertrophied in all patients. The authors declare that they have no competing interests. Deep Seated Pain at Back of Knee with Bending - Think of Mucoid The authors acknowledge some limitations to this study. ACL MUCOID DEGENERATION RADIOLOGY MRI - Radedasia Discussion: Treatment of ACL mucoid degeneration by arthroscopic resection is effective for . Accumulation of mucopolysaccharides at the meniscal interstitial area disrupts the collagen network and weakens the meniscus. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/. It may lead to knee pain. The rest of the surgery remained the same and all patients underwent mobile-bearing Oxford UKA. Others may make an appointment with their family doctors. Papers of special note have been highlighted as: of interest. (Table 2). 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. The end point was ascertained to be when the surgeon could pass a hook between the medial cortex of the lateral femoral condyle and the lateral border of the remaining ACL. If present in a patient undergoing unicompartmental knee arthroplasty, it can deteriorate the final outcome. To provide the highest quality clinical and technology services to customers and patients, in the spirit of continuous improvement and innovation. Faint word in ACL | DocHub But full ACL tears cannot be healed without surgery. We believe that meniscal mucoid degeneration with tear is not uncommon. This allows the doctor to see the knee structures more clearly. Raymond Won Shing Chan - Articles - Scientific Research Publishing > Follow SCIRP. Main symptoms are pain during terminal knee flexion (as in squatting) feeling of heaviness/tiredness in the knee. J Clin Med 10(2):315. https://doi.org/10.3390/jcm10020315, Article We reviewed previous reports and summarized clinical features and symptoms, including those found in our case. An anteriorly protruding ganglion (arrow) arising from an ACL ganglion cyst (arrowheads) is well seen on a proton density-weighted sagittal image. On table, the extent of impingement caused by the mucoid degeneration was gauged using an arthroscopy hook. The ACL can be injured or torn in a number of different ways. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is commonly treated with arthroscopic debridement of the ACL. The purpose of this study was to diagnose mucoid degeneration of ACL and to assess the effectiveness of arthroscopic treatment in these patients. https://doi.org/10.1177/03635465010290051301, Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Su Chan Lee, Kyung Won . Outcome of Arthroscopic Treatment of Mucoid Degeneration of the There was a statistically significant improvement in the mean IKDC and mean KSS of both the groups at 2years of follow-up as compared with their pre-operative scores (p<0.05). 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. PubMed The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.