Exclusion criteria was as follows: (1) patients with a previous history of having undergone reconstruction, repair or debulking of the ACL in the ipsilateral knee; (2) patients with a history of any surgery in and around the ipsilateral or contralateral knee, or ipsilateral hip or ankle joints; (3) patients with inflammatory arthritis; (4) patients with musculoskeletal and learning disorders and (5) patients diagnosed with mucoid degeneration of the PCL radiologically. A total of 442 patients (226 patients underwent debulking, 216 patients did not undergo debulking) were included. All the patients were operated on in a leg hanging position and under tourniquet control. 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. This content does not have an English version. Rehabilitation, orthophony, crenotherapy. Int J Curr Res Acad Rev 4(11):1824. Volar ganglion cyst excision. Medical search. Frequent questions : tissue degeneration marked by conversion of cell substance into a glutinous substance like mucus. The anterior cruciate ligament (ACL) is a key structure in the knee joint kinematics, as it resists anterior tibial translation and rotational loads. 4th ed. They cross each other to form an X with the anterior cruciate ligament in front and the posterior cruciate ligament in back. https://doi.org/10.3109/17453679209154722, Gibson PH, Goodfellow JW (1986) Stress radiography in degenerative arthritis of the knee. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. CIOS :: Clinics in Orthopedic Surgery Although a few studies such as the one by Lee etal. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Faint word in ACL | DocHub Depending on the severity of your injury, you may be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon). 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. Arthroscopic surgeries are key hole surgeries for joint disorders. Culmination of these results meant that even the patient satisfaction at 2years follow-up was better in the debulking group. Anterior Cruciate Ligament (ACL) Mucoid Degeneration The cause is not really known, but patients usually do not complain of instability. Discrete intraosseous ganglia are observed in 3/4 of the cases with mucoid degeneration of the ACL. Diagnosis. A painful injury where the upper arm bone dislocates out of its normal position with significant damage to the surrounding soft tissues. 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. 1). If present in a patient undergoing unicompartmental knee arthroplasty, it can deteriorate the final outcome. Correlation with operation methods in 200 knees. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). Seung Ho Chang - Articles - Scientific Research Publishing #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. Any use of this site constitutes your agreement to the Terms of Use and Privacy Policy and Conditions of Use linked below. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, . Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. 10, No. 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. As per study population statistics, the prevalence of medial meniscus tears (29.64%) in this study were congruent to the rates found in studies by Srivastava etal. Clin Orthop Surg 10(3):307314. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. Su Chan Lee, Kyung Won . He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. On table, the extent of impingement caused by the mucoid degeneration was gauged using an arthroscopy hook. Predetermined inclusion and exclusion criteria were used for sample collection. 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. What is thickening of the ACL? - AnswersAll PDF Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Plain radiographs were taken in anteroposterior and lateral views at 2years follow-up for radiological analysis in the form of implant failure in all patients or anterior tibial translation in group B by a blinded radiologist. Mucoid degeneration of the anterior cruciate ligament: Partial 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. https://doi.org/10.4055/cios.2018.10.3.307. The follow-up period was similar to that of Cha etal. Introduction to Arthroscopic Debridement Go to the Bones, Joints & Muscles Support Group. A coordinator will follow up to see if Mayo Clinic is right for you. 1 Brown MF, Dandy DJ: Intra-articular ganglia in the knee. Most surgeons recommend a program of physical therapy post-operatively to reduce pain and swelling, promote full range-of-motion, and improve knee function. 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]. c 24.5months post-operative radiograph showing no posterior translation of femur compared with pre-operative and immediate post-operative radiograph. These tests may include: Prompt first-aid care can reduce pain and swelling immediately after an injury to your knee. As this improvement might not be entirely due to PRP, high-end comparative studies are needed to confirm its efficacy. Another theory states that it is a consequence of herniation of a synovial pouch in the substance of the anterior cruciate ligament (ACL), and the subsequent synovial filling inside it; however, the major aetiology of MD-ACL still remains an enigma [4]. J Bone Jt Surg Ser B 81(2):304305. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Such meniscal tears are not appropriate for repair most of the time (Fig. Investigation, data curation, validation, writing original draft was done by U.S., A.M., S.G. and R.G. A total of 488 patients diagnosed with MD-ACL (clinically and radiologically) underwent surgery during this period, of which 46 patients (9.43%) were lost to the minimum 2-year follow-up criteria or to matching of groups. 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. The authors did not perform stress tests. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Accumulation of mucopolysaccharides at the meniscal interstitial area disrupts the collagen network and weakens the meniscus. Clin Radiol. . Arthroscopic management of mucoid degeneration of anterior cru This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. However, upon following-up with these patients, and gauging their clinical and functional parameters, complaints of rest pain and restriction of terminal flexion seemed to persist. A longer recovery period may reduce the risk of re-injury. Imagination. 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. Platelet-rich plasma (PRP) is known to influence musculoskeletal healing through multiple growth factors. The anterior cruciate ligament (ACL) is an important ligament in the knee. Part of Platelet-rich plasma (PRP) is known to influence musculoskeletal healing through multiple growth factors. Physical therapy typically begins 7-10 days after the procedure. The most common cysts in the knee region are popliteal also called Bakers cysts. Scribd adalah situs bacaan dan penerbitan sosial terbesar di dunia. . . MD-ACL lies in the grey area of a stable, yet functionally limiting condition that has the propensity to become relatively unstable after undergoing debulking. Only mobile-bearing UKA design was used in all the patients; hence the findings may differ in patients undergoing UKA with different implant designs such as fixed-bearing UKAs. Once considered a rare disease, it is probably a less diagnosed condition of knee pain. https://doi.org/10.1007/s00167-011-1433-0, Article Hence, the improvement in ROM, attenuation of rest pain and better long term functional outcome measures supported the hypothesis regarding the positive effect of debulking a MD-ACL in patients undergoing UKA. Lachmans test was performed intra-operatively in the immediate aftermath of the debulking, and only 27 (11.95%) knees were found to have grade one laxity with a firm end point, while no laxity was noted in the other knees. 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). Its function is to stabilize the knee while bending and rotating; the ACL also keeps the knee from shifting out of place or moving anteriorly (toward the front) with pivoting activities.