Symptomatic ACL mucoid degeneration in middle-age athletes

Samitier, Gonzalo; Waghchoure, Chaitanya; Vinagre, Gustavo

doi:10.1016/j.jor.2022.04.004

Cited by 6 publications

(7 citation statements)

References 44 publications

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“…Three studies reported mean preoperative International Knee Documentation Committee (IKDC) scores ranging from 29.1 to 48.3 [9, 13, 28]. Four studies reported on mean postoperative IKDC scores ranging from 71.0 to 82.5 [11, 15, 25, 32]. [9, 13, 22, 28].…”

Section: Resultsmentioning

confidence: 99%

“…Postoperative pain after partial or complete resection of the ACL can still persist and is most often due to associated pathologies such as meniscal and cartilage lesions [17]. Despite symptomatic relief, these patients are at a high risk for abnormal knee laxity due to decreased ACL volume [32], as shown by postoperative Lachman test results exhibited in this review. It has been reported that partial or complete debridement rarely results in symptomatic instability, however, the risk is higher for high‐demand individuals such as athletes [32].…”

Section: Discussionmentioning

confidence: 99%

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Partial debridement is the most commonly reported treatment option for mucoid degeneration of the anterior cruciate ligament: a systematic review

Vivekanantha

Diao

Kay

et al. 2023

Knee surg. sports traumatol. arthrosc.

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Purpose To determine clinical outcomes and risks of various management strategies for mucoid degeneration of the anterior cruciate ligament (MD-ACL). Methods Three databases MEDLINE, PubMed and EMBASE were searched from inception to January 29th, 2023 for literature outlining clinical outcomes for various management strategies of MD-ACL. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on satisfaction scores, visual analogue scale (VAS) scores, Lysholm scores, International Knee Documentation Committee (IKDC) scores, Knee Osteoarthritis and Outcome Scores (KOOS), range of motion and Lachman test were recorded. Results A total of 14 studies comprising 776 patients (782 knees) were included in this review. Partial debridement was reported in ten (71.4%) studies comprising 446 patients, showing signiicant improvements in VAS, Lysholm, IKDC scores and range of motion. Complete debridement was reported by two (14.2%) studies comprising 250 patients, and resulted in increases in Lysholm scores, KOOS, and range of motion. Reduction plasty was reported in two (14.2%) studies comprising 26 patients and showed improvements in VAS and Lysholm scores, and range of motion. Other methods of treatment included conservative management and ultrasound decompression. Complete debridement resulted in 10/23 (43%) patients with a positive Lachman test. This was followed by reduction plasty and partial debridement, with 5/26 (19.2%) and 45/340 (13.2%) patients respectively having positive Lachman or elevated knee arthrometer scores. Pivot shifting was only reported in studies on partial debridement and reduction plasty, with 14/93 (15.1%) and 1/21 (4.8%) patients have positive results, respectively. Conclusion The most commonly reported management strategy for MD-ACL is partial debridement with complete debridement, reduction plasty and conservative management as alternative options. Current operative management strategies place individuals at risk for ACL insuiciency. Information from this review can aid surgeons and clinicians in understanding what treatment options are best for this patient population, by understanding the reported clinical beneits and risks of each strategy. Level of evidence IV.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Partial debridement is the most commonly reported treatment option for mucoid degeneration of the anterior cruciate ligament: a systematic review

Vivekanantha

Diao

Kay

et al. 2023

Knee surg. sports traumatol. arthrosc.

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“…Mucoid degeneration of the anterior cruciate ligament (ACL) is a frequently underdiagnosed condition characterised by hypertrophy of the ACL due to accumulation of mucinous material [6, 29]. The frequency of mucoid degeneration of the ACL ranges from 1 to 13.8%; however, the condition tends to affect older individuals with a reported median age of 55.5 years [4].…”

Section: Introductionmentioning

confidence: 99%

Posterior tibial slope, notch width index and tibial tubercle to trochlear groove distance contribute to development of mucoid degeneration of the anterior cruciate ligament: a systematic review

Vivekanantha

Diao

Cohen

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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PurposeTo determine what knee morphological factors are associated with the development of mucoid degeneration of the anterior cruciate ligament (ACL). Methods Three databases MEDLINE, PubMed and EMBASE were searched from inception to January 29th, 2023 for literature outlining knee morphological factors that potentially lead to the development of mucoid degeneration of the ACL. The authors adhered to the PRISMA and R-AMSTAR guidelines as well as the Cochrane Handbook for Systematic Reviews of Interventions. Data on receiver operating characteristic (ROC) curve parameters such as area under the curve (AUC), sensitivity and speciicity, odds ratios, as well as p values for comparisons of values between mucoid degeneration of the ACL and control patients were recorded. The Methodological Index for Non-Randomized Studies (MINORS) score was used for all studies to perform a quality assessment of included studies. Results A total of 7 studies comprising 1326 patients (1330 knees) were included in this review. Four studies reported a signiicant association between increasing posterior tibial slope angles and mucoid degeneration of the ACL presence, with one study specifying that posterolateral tibial slope had a greater association than posteromedial tibial slope. Two studies reported a signiicant association between lower notch width index values and mucoid degeneration of the ACL presence. One study found that the presence of trochlear dysplasia was correlated with mucoid degeneration of the ACL and two studies found that increased tibial tuberosity-trochlear groove distance (TT-TG) was associated with mucoid degeneration of the ACL. Conclusion Increased posterior tibial slope, decreased notch width index, and elevated TT-TG and trochlear dysplasia were associated with the presence of mucoid degeneration of the ACL. Information from this review can aid surgeons in understanding what morphological features predispose their patients to the development of mucoid degeneration of the ACL. Identifying what features predispose patients to mucoid degeneration of the ACL can help determine if regular screening or preventative strategies are necessary. Level of evidence Level III.

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“… 3 This thickening of the ACL results from the accumulation of mucoid substance, containing mucoproteins and glycoprotein in the interfibrous space of the ligament. 3 , 4 While MDACL is a relatively rare pathology (1.8-9.2%), it may be the root cause of a substantial percentage of intraarticular cysts. 5 Cilengir et al.…”

Section: Introductionmentioning

confidence: 99%

ACL Mucoid Degeneration—Anterior and Posterior Arthroscopic Decompression for Combined Knee Flexion-Extension Deficit

Malinowski,

Koźlak,

Kennedy

et al. 2023

Arthroscopy Techniques

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Symptomatic ACL mucoid degeneration in middle-age athletes

Cited by 6 publications

References 44 publications

Partial debridement is the most commonly reported treatment option for mucoid degeneration of the anterior cruciate ligament: a systematic review

Partial debridement is the most commonly reported treatment option for mucoid degeneration of the anterior cruciate ligament: a systematic review

Posterior tibial slope, notch width index and tibial tubercle to trochlear groove distance contribute to development of mucoid degeneration of the anterior cruciate ligament: a systematic review

ACL Mucoid Degeneration—Anterior and Posterior Arthroscopic Decompression for Combined Knee Flexion-Extension Deficit

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