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. For such patients, decompression of the ganglion at arthroscopy or via CT guidance is indicated and provides prompt relief.3,5,6. Treatment is only required if there are otherwise unexplained symptoms. The most common mechanism is that of a sudden pivoting or cutting maneuver during sporting activity, which is commonly seen in football, basketball and soccer. 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. Usually there is no history of any significant trauma. 1998-2023 Mayo Foundation for Medical Education and Research. Flowchart representation of selection process of sample size, intervention process and outcome assessment. After collecting their demographic details, the ROM of the affected knee was noted, following which they were planned for surgery in the form of mobile-bearing UKA. 6 Antonacci VP, Foster T, Fenlon H, Harper K, Eustace S: Technical report: CT-guided aspiration of anterior cruciate ligament ganglion cysts. California Privacy Statement, Am J Sports Med 29(5):600613. Pre-operatively, patients were examined and clinicoradiologically confirmed for MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee. The patients clinical history and symptoms do not support an ACL injury. ), or their login data. Interested in more discussions like this? Anterior cruciate ligament (ACL) injuries. ACL Reconstruction is a surgical procedure to reconstruct the ligament in the center of your knee in order torestore its function after an injury. c 24.5months post-operative radiograph showing no posterior translation of femur compared with pre-operative and immediate post-operative radiograph. Does mucoid degeneration of ACL require surgery? - TimesMojo The pain and disability associated with an ACL injury prompt many people to seek immediate medical attention. The severity of the ACL injury is graded from 1 to 3. Instrumental treatment. At minimum 2years post-operatively, patients were called for a follow-up, and they were assessed clinically for ROM and stability by a blinded clinician not involved in the clinical care of the patients. Subsequently, from January 2019, the surgeons started debulking the MD-ACL. 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. Complete your request online or contact us by phone. Mucoid degeneration of the anterior cruciate ligament: Partial Paterno MV, et al. My knee pains while I sit on the floor or its difficult for me to stand or walk for a long time or I find its difficult to descend the stairs or my knee gets tired easily these days are the usual complaints. A single copy of these materials may be reprinted for noncommercial personal use only. These ganglia consist of myxoid material. The median age of the affected population is estimated to be 51years [5]. Close. 18 Apr 2021. Discrete intraosseous ganglia are observed in 3/4 of the cases with mucoid degeneration of the ACL. 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. It's important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk of ACL injury. 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 . A case of mucoid degeneration of the anterior cruciate ligament (ACL) is reported based on specific imaging features on MRI. Diagnosis is usually made on the MRI. Cureus | Anterior Cruciate Ligament Ganglion Cyst and Mucoid Close. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. ), or their login data. Method. 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. As we age, the connections between the collagen fibers that make up the meniscus begin to deteriorate, causing failure of the structure and tears due to stresses in the joint. A Retrospective Comparison of ACL Tear and Mucoid Degeneration MRI Sun H, Gill TJ. PubMed An ACL sprain is when the ACL is overstretched (but not torn). 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. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients.Materials and MethodsBetween December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis . Which of the following is an assumption of the psychoanalytic Informed written consent was obtained from all individual participants included in the study. Anterior cruciate ganglion cysts are probably more prevalent than stated in the literature. Skeletal Radiol 2001 Jun; 30(6): 312-5. [6] and Lintz etal. You can read more if you want. 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. Proton density-weighted sagittal demonstrates a diffusely increased size of the ACL with ill-defined increased signal and interspersed intact ACL fibers. 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. The left ureter was normal in the pelvis. 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 arthroplasty (UKA). 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 . Background: The anterior cruciate ligament (ACL) is the most commonly operated ligament of the knee. A surgical procedure that involves replacing a damaged, worn or diseased knee with an artificial joint to restore knees movement. Did you hear a loud pop or feel a "popping" sensation? This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. An ACL sprain is when the ACL is overstretched (but not torn). 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. 2001. 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]. Mumbai, Maharashtra, India. The anterior cruciate ligament (ACL) is the most commonly injured of the major knee ligaments. These patients were included in group A (na=216). He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. After a database search of 4,221 knee MRI examinations, Bergin et al. Among other conditions - osteoarthritis, osteopenia, spondylolisthesis- an MRI report showed "severe mucoid degeneration of the ACL" in my left knee. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Subsequently, the final sample included 442 patients who were followed-up for at least 2years after surgery (Fig. It can cause pain and to a meniscal tear. Ellman MB, et al. J Bone Jt Surg [Br] 68-B:608609, Kang SN, Smith TO, De Rover WBS, Walton NP (2011) Pre-operative patellofemoral degenerative changes do not affect the outcome after medial Oxford unicompartmental knee replacement: a report from an independent centre. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. During ACL reconstruction, the surgeon removes the damaged ligament and replaces it with a segment of tendon tissue similar to a ligament that connects muscle to bone. 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. 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). Knee Surg Sports Traumatol Arthrosc 19(8):13261333. 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.