Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. 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 Posterior Cruciate Ligament Leads to Roof Impingement with Anterior Cruciate Ligament: Case Report. In this study, the authors hypothesised that debulking the MD-ACL with a predetermined, objective endpoint relieves the patient of the rest pain caused by the impingement and improves terminal flexion and functional outcome, without compromising the integrity and stability of the UKA. 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. These patients were included in group A (na=216). One MRI was reported as a possible ganglion cyst or mucoid degeneration of the ACL, whereas all others were reported as either partial or complete tears of the ACL. https://doi.org/10.4103/0019-5413.128765, Article The samples collected from the five hospitals were 122 (group A: 58; group B: 64), 68 (group A: 35; group B: 33), 94 (group A: 46; group B: 48), 83 (group A: 41; group B: 42) and 75 (group A: 36; group B: 39), respectively. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. Considering a dearth of studies that evaluates the effect of debulking an ACL with mucoid degeneration, more prospective studies with larger sample size and longer follow-up period are encouraged to corroborate the findings of this study. Clinical History: 37 year-old male with no known injury, complaining of diffuse knee pain and stiffness, worsening over the last 3 months. Discussion: Treatment of ACL mucoid degeneration by arthroscopic resection is effective for . Return to play following anterior cruciate ligament reconstruction. https://doi.org/10.1186/s43019-022-00169-9, DOI: https://doi.org/10.1186/s43019-022-00169-9. Pre-operatively, patients were examined and clinicoradiologically confirmed for MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. Non-traumatic thickening of the ACL was associated with osteoarthritis and meniscal tears in almost all cases and showed increased signal intensity and ill-defined borders simulating acute ligamentous tears. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. 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. Truncation means that the . The time it takes to recover is approximately 3 months. Indian J Orthop 48(2):197202. A pre-study power analysis was done for a minimum sample size of 400, using dependent and independent variables involved in the study outcome. Inclusion criteria was as follows: (1) clinicoradiological confirmation of MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee joint; (2) patients with less than 10 of varus or 5 of valgus deformity and (3) patients with no flexion contracture. A total of 442 patients (na=216; nb=226) fulfilled the inclusion criteria and were followed up until a minimum of 2years post-surgery (mean: 252.46months; range: 2427.5months). He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. It is postulated that mucoid degeneration may be a predisposing factor to the formation of ACL ganglion cysts . 4 McIntyre J, Moelleken S, Tirman P: Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears . Enter your email address below and we will send you the reset instructions. Mucoid degeneration of the anterior cruciate ligament (ACL) has been shown to cause restricted terminal range of motion and rest pain. 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 . Diagnosis is usually made on the MRI. just over two decades ago [1], the interest in this condition has quickly gathered pace in the orthopaedic community. Rajani, A.M., Shah, U.A., Mittal, A.R.S. There's no set time frame for athletes to return to play. 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. Background: There has been a substantial increase in the amount of systematic reviews and meta-analyses published on the anterior cruciate ligament (ACL). 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. mucoid degeneration of acl mri. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. Go to the Bones, Joints & Muscles Support Group. 1). All the patients were operated on in a leg hanging position and under tourniquet control. TimesMojo is a social question-and-answer website where you can get all the answers to your questions. This study aims to compare functional and clinical outcomes of debulking the mucoid ACL in patients undergoing mobile-bearing unicompartmental knee . 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). 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. . The appearance can mimic acute or chronic interstitial partial tears of the ACL. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. PubMed It included all patients who were diagnosed with mucoid degeneration of ACL and underwent mobile-bearing Oxford partial knee arthroplasty between January 2017 and February 2020, by consecutive sampling method. [4]showed high percentages of laxity post debulking of MD-ACL, a finding which would not allow a surgeon to carry out a UKA after the debulking. Although a few studies such as the one by Lee etal. . The MR-findings of mucoid degeneration of the ACL include: an ill-defined ACL; an increased ligamentous girth He did total knee replacement on both side and now my mother is walking without aid. There have been only some reported cases of mucoid degeneration of the ACL in the English literature. In general, it takes as long as a year or more before athletes can safely return to play. Subsequently, from January 2019, the surgeons started debulking the MD-ACL. 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. 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. The severity of the ACL injury is graded from 1 to 3. Connect with thousands of patients and caregivers for support and answers. It is postulated that intraosseous extension may be a finding more often associated with pain (8a). 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Results: Visual analogue scale and Lysholm scores improved compared with preoperative scores, along with strength (anterior drawer test and Lachman test). Answered . K Munde: Substantial contributions to the design of the work, analysis of the data for 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. A single copy of these materials may be reprinted for noncommercial personal use only. Part of Rehabilitation, orthophony, crenotherapy. Let others know if this answer was helpful The authors did not perform stress tests. My MRI done in June states that I have very severe mucoid degeneration/partial thickness tearing of the ACL with the tibial spine tractional marrow edema. I know what the words mean. 21 yrs old Male asked about Mucoid degeneration of ACL, 2 doctors answered this and 92 people found it useful. The first resembles ganglia in other periarticular locations, presenting as a discrete fluid signal cystic structure within the substance or on the surface of the ACL(5a).3 The second form has been likened to a celery stalk in appearance.4 The ACL demonstrates diffuse thickening containing ill-defined intraligamentous T2-hyperintensity, which splays the intact ACL fibers (6a). Anyone else have this and how was it treated if at all? Reactive marrow edema (arrowheads) surrounds the intraosseous ganglia. The results found improved functional scores and pain scores compared with preoperative levels. 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. mucoid degeneration acl symptoms. Others may make an appointment with their family doctors. To summarize, debulking of mucoid ACL in patients undergoing unicompartmental knee arthroplasty significantly reduces the rest pain and improves the final range of motion of the knee joint, subsequently improving the overall functional and clinical outcome of the patient and resulting in greater patient satisfaction. Get your query answered 24*7 only on | Practo Consult . Treatment is only required if there are otherwise unexplained symptoms.