mucoid degeneration of acl physiotherapy

ACL mucoid degeneration is an uncommon pathological condition; the pathogenesis, prevalence, and association with other intra-articular knee structural damage are still poorly understood. Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. Knee. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. ANZ J Surg 73(9):712716. FOIA Second, methodological quality assessment showed that three studies had low methodological quality. Physiotherapy. Arthroscopy. Anterior cruciate ligament mucoid degeneration. The knee is a complex synovial joint that can be affected by a range of pathologies: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Kwee RM, Hafezi-Nejad N, Roemer FW, Zikria BA, Hunter DJ, Guermazi A, Demehri S. Association of Mucoid Degeneration of the Anterior Cruciate Ligament at MR Imaging with Medial Tibiofemoral Osteoarthritis Progression at Radiography: Data from the Osteoarthritis Initiative. The site is secure. 2023 BioMed Central Ltd unless otherwise stated. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Conditions that resembles the clinical findings are: Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. https://doi.org/10.1016/j.jclinepi.2009.06.005. Indian J Orthop 48(2):197202. Mucoid degeneration of ACL. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. J Sports Med Phys Fitness 48(4):483487, PubMed 2012;4 (2): 167-70. 8600 Rockville Pike Unauthorized use of these marks is strictly prohibited. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity that has been found in patients with pain and limited range of motion of the knee in association with a bulky ACL shown on magnetic resonance imaging (MRI). ADVERTISEMENT: Supporters see fewer/no ads. The reported restriction of range of movement was flexion deficit in four studies [3, 13, 15, 17], extension deficit in one study [14] and combined flexion and extension deficit in four studies [6, 16, 18, 19] (Table4). Orthop Traumatol Surg Res 96(4):400406, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. Sagittal T2-weighted MRI view showing intact anterior, Fig. Epub 2010 May 8. AJR Am J Roentgenol. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Risk factors Predisposing factors include the following 1: aging 2006;69(9):44952. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. in 1999 [ 1 ]. Pan African Medical Journal. The rate of simultaneous meniscectomy ranged from 13 to 44%. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Besides, the patient may also have trouble in moving. This appearance can mimic acute or chronic interstitial partial tears of the ligament. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. Symptoms included limited range of motion (ROM) and posterior knee pain. . What causes mucoid degeneration of ACL? https://doi.org/10.1007/s00167-011-1433-0, Article See this image and copyright information in PMC. Arthroscopy 20(2):141146. Role of ultrasound-guided decompression in management of mucoid degeneration of the anterior cruciate ligament. Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. PubMedGoogle Scholar. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. . Chudasama et al. Sasaki R, Nagashima M, Takeshima K, Otani T, Okada Y, Aida S, Ishii K. J Int Med Res. Epub 2021 Mar 8. Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures. Instrumental treatment. Method. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. An official website of the United States government. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Epub 2011 Feb 18. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-3615, Case 11: with Hoffa fat pad ganglion cyst, Case 12: tibial nerve schwannoma and ACL mucoid degeneration, Case 1: Complete ACL tear and meniscal tears, Case 2: Anomalous insertion of the medial meniscus, View Frank Gaillard's current disclosures, see full revision history and disclosures, anterior cruciate ligament ganglion cysts, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Mucoid degeneration of the anterior cruciate ligament, congenital or acquired synovial tissue entrapment between ACL fibers. Epub 2021 Nov 24. (2018) Radiology. Orthop Traumatol Surg Res. -, Hsu CJ, Wang SC, Fong YC, Huang CY, Chiang IP, Hsu HC. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. Anterior cruciate ligament reconstruction was required in only one young patient due to disabling instability. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Clipboard, Search History, and several other advanced features are temporarily unavailable. All nine studies were case series; six were retrospective and three were prospective studies. An official website of the United States government. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. J Knee Surg. 2013;15(1). The cruciate ligament have mechanoreceptors, which are responsible to detect any change in position of the knee, direction, speed and tension. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, most pronounced at 6-7 and small disc herniations at 5-6 and C4-5, with slight interval progression at 5-6. . Orthop Traumatol Surg Res 99(6):693697, Khanna G, Sharma R, Bhardwaj A, Gurdutta HS, Agrawal DK, Rathore AS (2016) Mucoid degeneration of the anterior cruciate ligament: partial arthroscopic debridement and outcomes. GG and AM interpreted the results and reviewed the manuscript. Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Third, clinical outcomes were reported using a variety of scores, so a data meta-analysis was not possible. All rights reserved. PMC Accessed 1 Mar 2021. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. There was an improvement in postoperative range of motion and outcome scores (Lysholm and International Knee Documentation Committee scores and the Knee Injury and Osteoarthritis Outcome Score). Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? (100%). Clipboard, Search History, and several other advanced features are temporarily unavailable. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Symptomatic ACL mucoid degeneration in middle-age athletes. This is basically an MRI diagnosis of expansion and increased signal of an intact ACL in a person with knee pain which is worse on knee flexion/bending. Mucoid degeneration of the anterior cruciate ligament. I get PT and acupuncture, have had several epidural injections, and am trying hard to avoid osteoporosis meds (was on bisphosphonates for many years many years ago) as well as spinal fusion. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Please enable it to take advantage of the complete set of features! Unable to load your collection due to an error, Unable to load your delegates due to an error. In six of the nine studies [6, 14, 16,17,18], arthroscopic debridement of the ACL was associated with simultaneous partial meniscectomy; this ranged from 13% in the study of Morice et al. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased signal intensity and a celery stalk appearance of intact fibers. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. The total number of patients with symptomatic instability was 18 out of 288 (6%). Please enable it to take advantage of the complete set of features! Before This site needs JavaScript to work properly. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Mucoid degeneration of both ACL and PCL. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Bethesda, MD 20894, Web Policies 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Careers. -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. The inclusion criteria for this study were (1) studies including symptomatic patients with mucoid degeneration of the ACL, (2) studies of 10 or more patients, (3) a minimum of 6months follow up and (4) patients treated conservatively or surgically (arthroscopic debridement with or without simultaneous ACL reconstruction). HHS Vulnerability Disclosure, Help 2008;24(6):642649. Federal government websites often end in .gov or .mil. National Library of Medicine Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a benign knee pathology, which is often indicated for surgical treatment if symptomatic. proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. It is lined by the synovial fluid, which provides the nutrition and plays an integral part in healing. See this image and copyright information in PMC. This site needs JavaScript to work properly. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 2. Arthroscopy. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Online ahead of print. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. The author(s) read and approved the final manuscript. 1. Epub 2013 Aug 27. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Other theories include Degenerative theory- MD could occur due to ageing.[3]. PMC 2021 Oct 21;2021:5879121. doi: 10.1155/2021/5879121. Bookshelf Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. These appearances must be differentiated from mucoid degeneration of the intact ACL. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Accessibility The anterior cruciate ligament (ACL) is an important ligament in the knee. [Diagnosis and treatment of anterior cruciate ligament cysts]. What is myxoid degeneration treatment? J Arthrosc Joint Surg 3(1):2833. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. The ligament is mainly responsible for restraining anterior translation of knee. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. 2011 Aug 1;19(8):1326-33. Epub 2018 Apr 21. did not report on this. 1. The origin of MDACL may be degenerative or traumatic. MDACL is differentiated from synovial cysts of the anterior cruciate ligament (ACL) where, in MDACL, mucoid tissue intermingles within ACL fibres and is not contained within a cyst [3]. Any discrepancy was resolved by the senior author. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. 2004;182(5):12831287. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42018087782). Ventura et al. Keywords: just over two decades ago [], the interest in this condition has quickly gathered pace in the orthopaedic community.Little is known about this condition that affects 1.8-5.3% of the population as per magnetic resonance imaging (MRI) diagnosis [2, 3]. It has recently been postulated that mucoid degeneration of the ACL is related to the medial knee compartment joint space loss in patients with osteoarthritis or in the OA risk group 6. Bethesda, MD 20894, Web Policies Skeletal Radiology. The mean age of patients ranged from 31 to 78years. Hamal B, Karmacharya M, Mangal Joshi K, Gorkhali R. J Nepal Health Res Counc. All studies focused on the outcome of arthroscopic debridement of MDACL, with no studies on conservative treatment. The https:// ensures that you are connecting to the However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. Mucoid degeneration of A C L is more common and literature has also reported many cases, but for PCL only few cases have been reported in English literature. Resnick D, Kransdorf MJ. Anatomopathology samples were collected in 18 cases. Bergin D, Morrison WB, Carrino JA et-al. official website and that any information you provide is encrypted Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. The https:// ensures that you are connecting to the Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. National Library of Medicine Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. FOIA Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. Postoperative pain relief ranged from 53.8 to 95%. Unauthorized use of these marks is strictly prohibited. Arthroscopic debridement may help relieve the anterior knee pain. Conclusions: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 2004;182(5):12837. Radiology. The clinical presentation is one of posterior pain with limited flexion. Unauthorized use of these marks is strictly prohibited. Average postoperative International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Scores (KOOS) were 71.2 (42.5 to 92.0) and 78.2 (26.4 to 99). Fourteen knees (48%) had limited flexion, on average 97 degrees. Arthroscopic findings. Orthopedics; anterior cruciate ligament; arthoscopy. Complete resection of the ACL without ACL reconstruction is a reliable treatment for symptomatic cases of mucoid degenerated ACL. It results in postoperative laxity, but rarely in frank instability. J Bone Joint Surg Ser B 81(2):304305. The purpose of this study was to investigate the outcomes of management of mucoid degeneration of the anterior cruciate ligament (MDACL) by performing a systematic review of methods of treatment that have been reported. Epub 2013 Aug 27. Chudasama CH, Chudasama VC, Prabhakar MM. J Bone Joint Surg Br. Rehabilitation, speech therapy, crenotherapy. volume33, Articlenumber:26 (2021) 2011 Jun;25(6):650-2. AJR Am J Roentgenol. Pain was posterior in 23 knees (80%). 4. FOIA https://doi.org/10.1007/s002560100336, Narvekar A, Gajjar S (2004) Mucoid degeneration of the anterior cruciate ligament. [16]. 2. Postoperative pain relief was reported in seven studies. Coronal proton density-weighted magnetic resonance, Coronal proton density-weighted magnetic resonance imaging shows a thickening of the anterior cruciate, Sagittal proton density-weighted magnetic resonance, Sagittal proton density-weighted magnetic resonance image shows ill-defined anterior cruciate ligament with increased, Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate, Pre-debridement arthroscopic view showing yellowish. Postoperative recovery was four weeks on average. Despite the low rate of complications in all studies, there was a high incidence of postoperative knee laxity, demonstrated by a positive Lachman test, in most studies. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. Level of Evidence: Level IV. 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. (10%) and highest in the study of Ventura et al. Conclusion: Treatment of ACL mucoid degeneration by this modality is effective in preventing recurrence, post-operative laxity and provides better functional outcome compared to the classical partial resection of the degenerated ACL. Download Citation | On Feb 1, 2023, O.R. 2004;182 (5): 1283-7. Histologically, there is a mucoid substance in connective tissue containing glycoproteins and mucoproteins [8]. 2018. http://journals.sagepub.com/doi/10.1177/2325967118786930, Pandey V, Suman C, Sharma S, Rao SP, Kiran Acharya K, Sambaji C (2014) Mucoid degeneration of the anterior cruciate ligament: management and outcome. Results: There was strong association with chondral lesions and meniscal tears. Presentation Patients usually present with nonspecific posterior knee pain with restriction of flexion. Reeducation. -. Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Mucoid degeneration of the anterior cruciate ligament. 1173185. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. https://doi.org/10.4103/0019-5413.128765, Article At last follow-up, the mean visual analogue scale score, International Knee Documentation Committee score, and Tegner Lysholm Knee score improved (p < 0.01). Anatomically, it is arranged in a crossed pattern with the Posterior Cruciate Ligament, forming an 'X', therefore, it is also known as cruciform ligament. Twelve partial and 17 total resections were performed. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Therefore, indications for ACL resection must be carefully selected. Check for errors and try again. The aetiology of MDACL is not clearly understood. That is usually the journal article where the information was first stated. : A Meta-Analysis. In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. 1992;159(2):35760. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J (2003) Methodological index for non-randomized studies (MINORS): development and validation of a new instrument. Arthroscopic debridement of the ACL resulted in good pain relief and improved range of movement in all studies, with postoperative improvement in the knee scores. Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Epub 2011 Feb 18. Postoperative Lachman test was positive in 40% of patients, and 6% of patients had symptomatic instability. Mucoid degeneration of the anterior cruciate ligament. official website and that any information you provide is encrypted Mucoid cystic degeneration of the cruciate ligament. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. There is no consensus on treatment and evidence is scarce. Mucoid degeneration of the anterior cruciate ligament (ACL) is regarded as a degenerative change in the ligament, which is clinically presented with pain on full extension or flexion in the middle-aged population. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Furthermore, this raises the question as to whether the symptoms (pain and diminished range of movement) were solely due to MDACL and not secondary to other associated pathological conditions. Indian J Orthop 46(5):561565. The rate of association between meniscal tears and MDACL ranged from 9 to 96%. Hide glossary Glossary. Postoperative ACL laxity is common after arthroscopic ACL debridement, however, symptomatic instability is not. Knee Surg Sports Traumatol Arthrosc. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). It contrasts with cystic lesions better known as synovial cysts or intercondylar fossa cysts. Mucoid degeneration of the anterior cruciate ligament. HHS Vulnerability Disclosure, Help Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH Epub 2018 Jan 2. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. Surgical treatment involves arthroscopic debridement of ACL, with partial or total resection, occasionally combined with ACL reconstruction. MeSH Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. Clin Orthop Surg. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. -Evaluated and planned treatment protocol in accordance with physician. Would you like email updates of new search results? Along with that, it also controls the internal rotation. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. Disclaimer. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. The site is secure. 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. and Ventura et al. Tamer Sweed. J Orthop. Mucoid degeneration is characterized by an increase in the mucoid ground substance in the connective tissue containing glycoprotein and mucoprotein [ 4 ]. After the literature search and exclusion of duplicates, 54 papers were retrieved: 12 articles were assessed for eligibility, and of these, 9 papers met the inclusion criteria and were included in the systematic review [3, 6, 13,14,15,16,17,18,19] (Fig. 1). Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. Characteristic: "celery stalk" appearance. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Arthroscopic resection of ACL mucoid degeneration is effective for treating pain and flexion limitation, but at the expense of anterior laxity. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Disclaimer. ACL debridement was partial in all studies except for those by Lintz et al. 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. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. 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. Khanna et al. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach.