No writing assistance was utilized in the production of this manuscript. Journal of the American Academy of Orthopaedic Surgeons. Results: Visual analogue scale and Lysholm scores improved compared with preoperative scores, along with strength (anterior drawer test and Lachman test). The abnormal sliding within the knee also can hurt cartilage. Some patient may also complain of pain with full knee extension. 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. b Immediate post-operative radiograph showing no posterior translation of femur compared with pre-operative radiograph. 1 Brown MF, Dandy DJ: Intra-articular ganglia in the knee. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. Treatment of Atherosclerotic Disease of the Femoral Artery: Randomized Controlled Trials and Meta-Analyses. Springer Nature. 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 . Generally, we know little about this condition. 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). Patients with mucoid ACL undergoing mobile-bearing UKA at five different centres by five different arthroplasty surgeons were included. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Very minor tears (sprains) may heal with non-surgical treatments and regenerative medicine therapy. The appearance can mimic acute or chronic interstitial partial tears of the ACL. 21 yrs old Male asked about Mucoid degeneration of ACL, 2 doctors answered this and 92 people found it useful. Contact us. Anyone else have this and how was it treated if at all? Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. The power of the study for the corrected model was estimated to be 92% for the aforementioned sample size when keeping the value of as 0.05, the degree of freedom (df) as 1, and adjusted R2 as 0.023. This was a prospective, cohort, multicentric study conducted in five centres. Instrumental treatment. Surgery is typically not needed. Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. 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 authors acknowledge some limitations to this study. These appearances must be differentiated from mucoid degeneration of the intact ACL. Treatment: For symptomatic knees surgical debulking /debridement in which thickened part of the ACL is shaved off, is the treatment of choice. However, young patients . The side of my knee is achy as well and I had a meniscus repair in 2012 and have had a few injections there as well. Unicompartmental knee arthroplasty (UKA) has rapidly emerged as a superior surgical option to total knee arthroplasty for bone-on-bone osteoarthritis owing to less trauma to the surrounding soft tissue, more conservative bone cuts, minimal bleeding, smaller incision, a better range of motion (ROM), faster recovery, preserved kinematics, higher rate of implant survival and decreased chances of major complications such as thromboembolism, cardiac arrest and stroke [9]. Mucoid degeneration of the anterior cruciate ligament: can platelet-rich plasma combined with reductionplasty provide better results? A single copy of these materials may be reprinted for noncommercial personal use only. Accessed Nov. 13, 2018. Patients were followed up post-surgery for rehabilitation. Both the groups were matched in terms of age, body mass index, pre-operative ROM, pre-operative International Knee Documentation Committee (IKDC) score [17] and pre-operative Knee Society score (KSS) [18]. https://link.springer.com/10.1007/s00590-021-03198-4. Rehabilitation, speech therapy, crenotherapy. Mucoid degeneration of the ACL is a rare cause of knee pain in the middle-aged patient group, without knee instability. The severity of the ACL injury is graded from 1 to 3. Knee Surgery & Related Research Patient-related outcome measures, rest pain, clinical outcomes, and subjective patient satisfaction were recorded and compared at 2years follow-up. Advertising revenue supports our not-for-profit mission. Mumbai, Maharashtra, India. 1st ed. [20], Chudasama etal. Indian J Orthop 48(2):197202. Hence, we targeted a minimum sample size of 400 patients. > Follow SCIRP. I remember that Dr. Jain came out from his clinic to see my mother because my mother was not able walk a single step. [22], Pandey etal. Clin Radiol. The anterior cruciate ligament (ACL) is an important ligament in the knee. A steeper PTS angle, decreased notch width index, and transverse notch angle are significantly associated with the presence of mucoid degeneration of the anterior cruciate ligament in symptomatic MD-ACL patients. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. PubMed Two characteristic MR appearances have been described for ganglion cysts of the ACL. Anterior cruciate ganglion cysts are probably more prevalent than stated in the literature. https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/. Investigation, data curation, validation, writing original draft was done by U.S., A.M., S.G. and R.G. This article belongs to the Special Issue on Radiation Therapy in the Treatment of Cancer < 1 2 3. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. 3, 2018 www.ecios.org Mucoid degeneration (MD . The results found improved functional scores and pain scores compared with preoperative levels. . Papadakis MA, et al., eds. Health. Discrete intraosseous ganglia are observed in 3/4 of the cases with mucoid degeneration of the ACL. Despite integrity and status of cruciates being paramount in a UKA, no study has evaluated the effect of debulking MD-ACL in this procedure. https://doi.org/10.4055/cios.2018.10.3.307. . This study aims to compare functional and clinical outcomes of debulking the mucoid ACL in patients undergoing mobile-bearing unicompartmental knee . The patients clinical history and symptoms do not support an ACL injury. 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. Follow us on social media for the latest updates, Future Medicine Ltd, Unitec House, 2 Albert Place, London, N3 1QB, UK, We use cookies to improve your experience. This course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees. model of self-care at home: Medical treatment for an ACL injury begins with several weeks of rehabilitative therapy. https://doi.org/10.1007/s00167-011-1433-0, Article The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. This site complies with the HONcode standard for trustworthy health information: verify here. It may lead to knee pain. ACL Injury Grades. Knee Surg Sports Traumatol Arthrosc 21(3):658663. Knee Surg & Relat Res 34, 40 (2022). Follow the R.I.C.E. Methodology: Five patients who were diagnosed as a case . Physiotherapy. This study showed that the patients who underwent debulking had statistically superior knee function, lesser rest pain and greater satisfaction rates at 2years of follow-up compared with those in whom MD-ACL was not debulked. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008 (5). Truncation means that the . b Open debulking of mucoid ACL under direct vision using 15-number blade. CAS [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. 1998 Oct;53(10):771-3. It results in postoperative laxity, but rarely in frank instability. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, . He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. MRI has been established as the gold standard imaging modality for the diagnosis of MD-ACL based on the criteria laid out by Bergin etal. [] found the incidence of mucoid degeneration in their study population to be 1.0%.Most of their reported cases were incidental findings without contributory symptoms. Score: 4.7/5 (45 votes) . This study used PRP to augment the weakened ACL and followed patients for 1 year to assess outcomes. (3a) A proton density-weighted sagittal image at the same level demonstrates increased signal within the enlarged anterior cruciate ligament (arrows) with faintly identified ACL fibers. 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. Acta Orthop Scand 63(5):497501. Pre-operatively, patients were examined and clinicoradiologically confirmed for MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. 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. New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Questions just answered: mucoid degeneration of acl physiotherapy. 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. Background. what causes mucoid degeneration of acl. It's a site that collects all the most frequently asked questions and answers, so you don't have to spend hours on searching anywhere else. . There is little evidence investigating the effect of MD-ACL in patients undergoing a UKA in the orthopaedic literature. Clinical History: 37 year-old male with no known injury, complaining of diffuse knee pain and stiffness, worsening over the last 3 months. Int J Curr Res Acad Rev 4(11):1824. Sep 2017 - Feb 20186 months. Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament Clinics in Orthopedic Surgery Vol. Various techniques have been proposed for the debulking of MD-ACL including arthroscopic debridement using shaver or radiofrequency ablation, with or without notchplasty, that have shown to give good clinical results [8, 19]. The demographic distribution of study population with respect to the mean age, gender distribution and the side affected was similar to the recent studies done on the MD-ACL as a standalone entity [2, 3, 5, 8]. Do Men Still Wear Button Holes At Weddings? Often these tears can occur with minimal load and trauma. Scribd adalah situs bacaan dan penerbitan sosial terbesar di dunia. But full ACL tears cannot be healed without surgery. . 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. This association has not yet been proven. However, all of these debridements were done under arthroscopy, whereas the surgeons in this study progressively debulked the ACL by open method using a 15-number blade, under direct vision. These include pristine lateral and patellofemoral compartments, correctable varus deformity, less than 1015 of fixed flexion deformity, flexion of more than 100, and functionally intact collateral ligaments and cruciates [10,11,12,13,14,15]. https://doi.org/10.1302/0301-620X.93B4.25562, Mittal A, Meshram P, Kim WH, Kim TK (2020) Unicompartmental knee arthroplasty, an enigma, and the ten enigmas of medial UKA. 2014;42:1567. 18 Apr 2021. Conclusions: 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. On exposure of the joint, ACL was looked for in terms of integrity and any degenerative changes. Make a donation. The excised ACL tissue was sent for histopathological confirmation of mucoid degeneration. Discussion: Treatment of ACL mucoid degeneration by arthroscopic resection is effective for . When the arthroscopy hook was attempted to be passed between the lateral femoral condyle and the lateral aspect of the ACL, it was noticed that the impinging fibers of the mucoid ACL blocked its passage, thereby not allowing the hook to be passed between the lateral femoral condyle and the lateral aspect of the ACL, which is otherwise possible in cases with normal ACL. 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%). A pre-study power analysis was done for a minimum sample size of 400, using dependent and independent variables involved in the study outcome.