Two characteristic MR appearances have been described for ganglion cysts of the ACL. 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]. : tissue degeneration marked by conversion of cell substance into a glutinous substance like mucus. Mucoid degeneration of the anterior cruciate ligament (ACL) is a common pathology but is often unknown and underdiagnosed. They are frequently seen at joints and tendons of the wrist but are rare in the region of knee joint. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Setback to comeback: Twin sisters return to the basketball court after ACL tears, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, NSF Certified for Sport Nutritional Supplements. 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. On exposure of the joint, ACL was looked for in terms of integrity and any degenerative changes. Knee Surg & Relat Res 34, 40 (2022). Knee 27(5):13321342. [2]. Cookies policy. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. Early reconstruction should be considered in younger patients with It happens to everyone in the country from little girls to middle- Family. Subsequently, the final sample included 442 patients who were followed-up for at least 2years after surgery (Fig. Do any specific movements seem to improve or worsen your symptoms? Mucoid degeneration of the anterior cruciate ligament: Partial The anterior cruciate ligament (ACL) is an important ligament in the knee. . CIOS :: Clinics in Orthopedic Surgery . After surgery you'll resume another course of rehabilitative therapy. 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. No writing assistance was utilized in the production of this manuscript. This allows the doctor to see the knee structures more clearly. 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. https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/. The ortho I saw is a spine guy and said the knee didn't . Patient having mucoid degeneration of ACL seeks multiple orthopedic consultation and most of the time treating orthopedican miss its diagnosis either because of lack of experience or rare cause of pain unless doctor sought magnetic resonance imaging (MRI) of knee. ACL Ganglion Cysts - Radsource These cysts have a variable MR appearance and are not always confined to the substance of the ligament. T2-weighted sagittal view demonstrates localized fluid signal within the ACL (arrows). Patients were followed up post-surgery for rehabilitation. INTRODUCTION Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a well-recognized pathology characterized by the degradation of collagen fibers and infiltration of a . 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. 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. Cite this article. [22]. Generally, we know little about this condition. [6] and Lintz etal. 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). It is a very rare cause of knee pain and can be diagnosed preoperatively on MRI. 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. Sigmund Freud emphasized the importance of the unconscious mind, and a primary assumption of Freudian theory is that the unconscious mind governs behavior to a greater degree than people suspect.Indeed, the goal of psychoanalysis is to make the unconscious conscious. Knee Surg Relat Res 33(1):26. https://doi.org/10.1186/s43019-021-00110-6, Kennedy JA, Mohammad HR, Mellon SJ, Dodd CAF, Murray DW (2020) Age stratified, matched comparison of unicompartmental and total knee replacement. Mucoid Degeneration of Posterior Cruciate Ligament Leads to Roof Impingement with Anterior Cruciate Ligament: Case Report. Corroborating these findings were the improvements and the final PROMs of both the groups which corresponded with the findings of the literature review by Sweed etal. Seung Ho Chang - Articles - Scientific Research Publishing During the physical exam, your doctor will check your knee for swelling and tenderness comparing your injured knee to your uninjured knee. Mucoid degeneration of the anterior cruciate ligament: Partial Plain radiographs of all the patients taken in anteroposterior and lateral views (in standing) at 2years follow-up showed no signs of implant failure in any patient. Mucoid degeneration of the anterior cruciate ligament: a case report Contact us. The median age of the affected population is estimated to be 51years [5]. c End-point of debulking when the surgeon can pass the arthroscopy hook between the medial cortex of lateral femoral condyle and lateral border of the native ACL effortlessly. Anyone else have this and how was it treated if at all? Mucoid degeneration of the anterior cruciate ligament Int J Sports Phys Ther 10(1):5261, PubMed An ACL sprain is when the ACL is overstretched (but not torn). Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity with disputed theories of origin [1,2,3,4]. was responsible for physiotherapy, writing review, editing and project administration. . Answered . The portal can access those files and use them to remember the user's data, such as their chosen settings (screen view, interface language, etc. In patients undergoing UKA and diagnosed with mucoid degeneration of the ACL, controlled debulking of the ACL provides better functional outcomes as compared with non-debulking of the mucoid ACL. Interested in more discussions like this? Anterior knee pain is the more common complaint. On inter-group comparison, VAS score for rest pain of the debulking group (0.130.46) was also found to be lower than the non-debulking group (2.640.95) (p<0.05). The most common cysts in the knee region are popliteal also called Bakers cysts. Mucoid degeneration of ACl is a rare pathological process involving knee joint. what causes mucoid degeneration of acl. By using this website, you agree to our 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. At arthroscopy, the ACL appeared homogenous, bulbous, and hypertrophied in all patients. A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Love. After surgery patient is allowed to walk from the next day. The excised ACL tissue was sent for histopathological confirmation of mucoid degeneration. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. The Infona portal uses cookies, i.e. The cruciate ligaments control the back and forth motion of your knee. An ACL sprain is when the ACL is overstretched (but not torn). 1998 Oct;53(10):771-3. was the primary surgeon and was responsible for the conceptualization, methodology, supervision, writing review and editing. When a cruciate ligament ganglion is discovered incidentally, no intervention is necessary. Terms and Conditions, The purpose of this study was to diagnose mucoid degeneration of ACL and to assess the effectiveness of arthroscopic treatment in these patients. . Results: Visual analogue scale and Lysholm scores improved compared with preoperative scores, along with strength (anterior drawer test and Lachman test). J Orthop Traumatol. PubMed 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. Patients will . The time it takes to recover is approximately 3 months. He did total knee replacement on both side and now my mother is walking without aid. The authors declare that they have no competing interests. Surgery is typically not needed. Hence, we targeted a minimum sample size of 400 patients. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. It can be secondary to trauma, or simply degeneration caused by meniscal injury, osteoarthritis or chondral damage [2]. https://doi.org/10.4103/0019-5413.101037, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J (2018) Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament. With an increasing trend of UKA being performed worldwide, the role of addressing concomitant MD-ACL is vital in improving the overall outcome of the patient without causing any instability or implant failure, as shown in this study. 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. For such patients, decompression of the ganglion at arthroscopy or via CT guidance is indicated and provides prompt relief.3,5,6. 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. The treatment alternatives, indications for the planned procedure and risks were discussed with her in detail and an informed consent was obtained. UTE-T2* versus conventional T2* mapping to assess posterior cruciate https://doi.org/10.1007/s00167-011-1433-0, Article Do Men Still Wear Button Holes At Weddings? Reeducation. https://doi.org/10.1016/j.knee.2020.06.004, Article https://doi.org/10.2214/ajr.182.5.18212835, Article Others may make an appointment with their family doctors. [7] have documented the presence of flexion contracture, we did not notice the same in any patient from the recruited sample size.