Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 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. The scores were then compiled and statistically analysed using SPSS-24 software to understand if the debulking resulted in any significant difference in the outcomes. [] 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. Terms and Conditions, What is your diagnosis? Mentioning: 2 - We report a case of mucoid degeneration of the anterior cruciate ligament (ACL). [21] and Ventura etal. [5]. Furthermore, the ancillary MR findings of an ACL tear, such as bone bruises and the MR anterior drawer sign, are absent. https://doi.org/10.1302/0301-620X.81B2.0810304, Article [22], Pandey etal. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. If your activities do not involve making pivoting movements on the knee, physical therapy rehabilitation may be all you need. The demographic data of the study population is presented in Table 1. It can cause pain and to a meniscal tear. An anteriorly protruding ganglion (arrow) arising from an ACL ganglion cyst (arrowheads) is well seen on a proton density-weighted sagittal image. While both the groups showed improvements in the functional scores post-surgery, which could be attributed to the UKA primarily, the finding that patients in whom debulking was done had better mean IKDC and mean KSS at 2years follow-up confirmed the study hypothesis that debulking improves the long-term outcome in patients with MD-ACL undergoing UKA. Plain radiographs in lateral view (in standing) of the left knee of patient number 164 from group B (Left to Right): a Pre-operative radiograph for baseline position of posterior femur and tibia. 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. It provides objective end points for open debulking of mucoid ACL in these patients and, being a multicentric study, it entails external validity of this procedure in a diverse population. 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. 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]. It may lead to knee pain. Manage cookies/Do not sell my data we use in the preference centre. Sep 2017 - Feb 20186 months. Background: There has been a substantial increase in the amount of systematic reviews and meta-analyses published on the anterior cruciate ligament (ACL). 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. 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. He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. 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. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Once considered a rare disease, it is probably a less diagnosed condition of knee pain. A.R. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, Additional Professor, Department of Orthopaedics, AIIMS Jodhpur, Jodhpur, Rajasthan, 342005, India, Senior Resident, Department of Orthopaedics, AIIMS Jodhpur, Jodhpur, Rajasthan, 342005, India. ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. Mucoid degeneration of the anterior cruciate ligament (ACL) has been shown to cause restricted terminal range of motion and rest pain. [5] and Chudasama etal. Arthrosc Tech 7(5):e459e463. Mucoid degeneration of the anterior cruciate ligament (ACL) is a common pathology but is often unknown and underdiagnosed. Mucoid Degeneration of Posterior Cruciate Ligament Leads to Roof Impingement with Anterior Cruciate Ligament: Case Report. 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. 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. We describe Arthroscopic near total debridement of mucoid degenerated ACL in . 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 severity of the ACL injury is graded from 1 to 3. If left untreated, a small ACL tear will increase in size, causing more pain and increasing the laxity in the knee. Ganglion cysts are filled with gelatinous and viscous fluid in the neighbourhood of joints or tendon sheaths. The authors declare that they have no competing interests. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. 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. 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. This site complies with the HONcode standard for trustworthy health information: verify here. 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. 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. Arthroscopic surgeries are key hole surgeries for joint disorders. Evaluate the TCO of your PACS download >, 750 Old Hickory Blvd, Suite 1-260Brentwood, TN 37027, Focus on Musculoskeletal and Neurological MRI, The Anterior Meniscofemoral Ligament of the Medial Meniscus. . By using this website, you agree to our model of self-care at home: Medical treatment for an ACL injury begins with several weeks of rehabilitative therapy. (wikipedia.org)Rarely, intraosseous ganglion cysts occur, sometimes in . Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. 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). on nine studies [8]. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. 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. 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. 1st ed. 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). Informed written consent was obtained from all individual participants included in the study. . Mucoid degeneration of the anterior cruciate ligament: can platelet-rich plasma combined with reductionplasty provide better results? 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 . Imagination. By a paramedian incision and mini-midvastus arthrotomy, the joint was exposed. Treatment is only required if there are otherwise unexplained symptoms. Shelbourne Knee Center recommends activity modification and rest, medications, injections and/or physical therapy as the initial treatment(s). Clin Orthop Relat Res 248:1314, Hotchen AJ, Melton JTK (2018) Radiofrequency ablation for mucoid degeneration of the anterior cruciate ligament. After surgery patient is allowed to walk from the next day. 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. These findings were in line with the findings published by Cha etal. The results found improved functional scores and pain scores compared with preoperative levels. just over two decades ago [1], the interest in this condition has quickly gathered pace in the orthopaedic community. Notchplasty is an ancillary surgical procedure that consists of reshaping and widening of the intercondylar femoral notch, historically developed and performed with the aim to avoid ACL graft impingement and improve visualization of the lateral wall of the femoral notch during ACLR surgery. They assessed the stability of the joint with the Lachman test intra-operatively, confirming it to be either grade zero or one, with firm end point, before commencing with the UKA [16].
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