J Bone Joint Surg Br. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. However, in most studies a proportion of patients simultaneously underwent other arthroscopic procedures for associated pathological knee conditions (44% meniscectomies in the study of Cha et al.). If arthroscopy is performed, the ligament may appear entirely normal, especially using the standard anterior portal approach. Before Arthroscopic debridement may help relieve the anterior knee pain. Preoperative magnetic resonance imaging (MRI), Fig. Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. https://www.physio-pedia.com/index.php?title=Anterior_Cruciate_Ligament_(ACL)_Mucoid_Degeneration&oldid=253974, Difficulty in climbing stairs, cross-leg sitting, squatting, Primary condition- Osteoarthritis, degenerative menisci, meniscal tear, Impingement of the soft tissue in the vicinity. AJR Am J Roentgenol. Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar et al. MM and A performed the literature search, and data analysis. J Arthrosc Joint Surg 3(1):2833. Postoperative pain relief ranged from 53.8 to 95%. Online ahead of print. [3] and in 1% of patients (3 of 106 knees) in the study of Kim et al. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. AJR Am J Roentgenol. MeSH 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). 8600 Rockville Pike Bethesda, MD 20894, Web Policies Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Generally, we know little about this condition. Epub 2008 Apr 18. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. Level of Evidence: Level IV. Arthroscopy 20(2):141146. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). https://doi.org/10.4055/cios.2018.10.3.307, University Hospitals of Derby and Burton, Uttoxeter Rd, Derby, DE22 3NE, UK, Trauma and Orthopaedic Speciality Trainee, West Midlands Deanery, Birmingham Rotation, Birmingham, UK, University Hospitals Plymouth NHS Trust, Plymouth, UK, University of Alexandria, Alexandria, Egypt, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Walsgrave, Coventry, CV2 2DX, UK, You can also search for this author in Keywords: California Privacy Statement, Terms and Conditions, This systematic review has some limitations. 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). Papadopoulou P. The celery stalk sign. Cookies policy. . J Sports Med Phys Fitness 48(4):483487, PubMed Intact fibers are best seen on T2WI. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. In this review, the mean age of patients ranged from 31 to 78years; mean age was highest in the study of Kim et al. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. 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. Two reviewers independently screened the titles and abstracts of the retrieved records for eligibility. had the largest number of patients (91) with a mean age of 61 years, which was the oldest study population amongst the nine studies [16]. 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. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Characteristic: "celery stalk" appearance. Score: 4.7/5 (45 votes) . Eight studies showed postoperative improvement in range of motion, whereas Khanna et al. https://doi.org/10.1007/s00167-011-1433-0, Article Rehabilitation, speech therapy, crenotherapy. Epub 2018 Aug 22. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. 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. This ranged from 90 to 95% in all studies, except in the report by Kim et al., where only 53.8% of patients (57/106) had complete pain relief after surgery. A historical cohort of patients who underwent arthroscopic total or partial excision of the anterior cruciate ligament due to mucoid degeneration between 2011 and 2014 were reviewed. Bookshelf 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]. Hotchen AJ, Demetriou C, Edwards D, Melton JTK. They respond well to a judicious arthroscopic release of the ACL with notchplasty. Level of evidence: Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. The success of treatment for MDACL and the subsequent risk of instability is not known. This site needs JavaScript to work properly. Mucoid degeneration of the anterior cruciate ligament. Physical therapy typically begins 7-10 days after the procedure. All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). Read More Created for people with ongoing healthcare needs but benefits everyone. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). Meniscectomy was undertaken in 11 cases (41%). 2. Cho SD, Youm YS, Lee CC et-al. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. in 1999 [1]. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. There is strong association between MDACL and chondral and meniscal lesions, which may support the theory that MDACL is a degenerative process. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. https://doi.org/10.1046/j.1445-2197.2003.02748.x, Ekhtiari S, Horner NS, Bedi A, Ayeni OR, Khan M. The learning curve for the Latarjet procedure: a systematic review. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. The rate of simultaneous meniscectomy ranged from 13 to 44%. Later studies reported that changes consist of mucoid Results degeneration, neovascularisation, and tendon sheath hyper- Nineteen patients met the inclusion criteria and were inclu- trophy. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT 2,375 views Sep 15, 2019 23 Dislike Dr. Prateek Joshi- Ortho 1.02K subscribers Notice Age-restricted video (based on Community Guidelines). ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. The site is secure. Arthroscopy. Ligaments hold our bones together and allow us to bend, twist, pivot and rapidly accelerate and decelerate and yet maintain the stability of our joints. The site is secure. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. 6. -, Fealy S, Kenter K, Dines JS, Warren RF. National Library of Medicine Background: Mucoid degeneration of the anterior cruciate ligament (ACL) is an uncommon non-traumatic cause of knee pain and motion restriction, typically seen in a middle-aged population. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Arthroscopic findings. 8600 Rockville Pike Int J Curr Res Aca Rev 4(11):1824 http://www.ijcrar.com/abstractview.php?ID=228&vol=4-11-2016&SNo=3, Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI (2008) Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Risk factors Predisposing factors include the following 1: aging This bicentric, retrospective cohort study with an average follow-up of 6years involved 27 patients (29 knees) presenting with symptomatic ACL mucoid degeneration validated by magnetic resonance imaging (MRI). Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. That is usually the journal article where the information was first stated. NCI CPTC Antibody Characterization Program. Quadriceps and hamstring weakness are common features of people with symptomatic degenerative meniscal tears Surgery may address the structural injury, but . 2022 Mar;50(3):3000605221084865. doi: 10.1177/03000605221084865. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Morice et al. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. 2010 Jun 1;96(4):400-6. Quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Orthop Traumatol Surg Res. Each study was scored 02 on each question, with a global ideal score of 16. It is a chronic degenerative change of a bulky ACL that may lead to notch . Skeletal Radiology. Rehabilitation, orthophony, crenotherapy. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. PMC Arthroscopy. A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion . Roberts CC, Towers JD, Spangehl MJ et-al. After arthroscopic debridement of the lesion, the patient regained full range of motion of the knee and were pain-free at follow-up. . Provided by the Springer Nature SharedIt content-sharing initiative. and transmitted securely. Online ahead of print. 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. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. 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. FOIA Sep 2017 - Feb 20186 months. HHS Vulnerability Disclosure, Help Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Physiotherapy. Clinical Outcomes, Return to Sports, and Patient Satisfaction After Anterior Cruciate Ligament Reconstruction in Young and Middle-Aged Patients in an Asian Population-A 2-Year Follow-up Study. Epub 2018 Jun 13. CAS proposed reduction plasty, which is reduction of the ACL to normal volume without excision of all mucoid tissue. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. The mean age at the time of surgery was 57 years (range, 31 to 78 years). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 2001;30(6):312315. Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. 2019 Jun;32(6):577-583. doi: 10.1055/s-0038-1660514. The aetiology of MDACL is not clearly understood. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. -Evaluated and planned treatment protocol in accordance with physician. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. Google Scholar, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C (2008) Mucoid metaplastic-degeneration of anterior cruciate ligament. 2009. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Patients will . Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J. Clin Orthop Surg. Unauthorized use of these marks is strictly prohibited. [18] did not comment on an association between MDACL and chondral or meniscal lesions: after the exclusion of that report, the total number of patients with associated chondral lesions was 226 out of 275 patients (82%) and 190 patients had meniscal lesions (69%). . Mucoid degeneration, is the irreversible degeneration of the tissue with the infiltration of mucin(glycosaminoglycans) within the fibers[1][2]. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Introduction: ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. 3. Epub 2018 Jan 2. 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. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. The presence of intraligamentous mucoid degeneration in the ACL is demonstrated as a source of knee pain without instability and partial ACL debridement did not preclude adequate knee stability. There was more than 20% loss to follow up in the study of Kim et al., while the three prospective studies had no loss to follow up [13, 14, 18]. (100%). The site is secure. Federal government websites often end in .gov or .mil. 2012 Sep;46(5):561-5. doi: 10.4103/0019-5413.101037. Symptomatic ACL mucoid degeneration in middle-age athletes. Epub 2018 Apr 21. government site. 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. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. 1. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The authors declare that they have no competing interests. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist [9]. 2007;245 (3): 916-7. 2011. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. There was strong association between degenerative changes and MDACL (82% having chondral and 69% meniscal lesions), which might suggest that MDACL is a degenerative process. Careers. Categories were determined in accordance with the study of Ekhtiari et al. JBR-BTR. Hamdaoui and others published Le signe de la branche de cleri | Find, read and cite all the research you need on ResearchGate Five studies demonstrated improved postoperative functional outcome scores compared to preoperative scores [6, 14, 16, 18, 19]. The .gov means its official. https://doi.org/10.1016/j.arthro.2008.02.004, Morice A, Coupry A, Lintz F, Robert H (2013) Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases. -, Hodler J, Haghighi P, Trudell D, Resnick D. The cruciate ligaments of the knee: Correlation between MR appearance and gross and histologic findings in cadaveric specimens. Arthroscopy. The need for delayed ACL reconstruction should be discussed preoperatively, especially if complete resection of the ACL is to be performed. Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known entity. 2012;4 (2): 167-70. Methods: Any discrepancy was resolved by the senior author. Background: Mucoid degeneration itself is described as a yellow or brown substance which can be either seen through the most anterior fibers of the ACL or found by probing between them [ 19, 35] (Fig. 2013;15(1). The https:// ensures that you are connecting to the ADVERTISEMENT: Supporters see fewer/no ads. Please enable it to take advantage of the complete set of features! Fourteen knees (48%) had limited flexion, on average 97 degrees. A systematic literature search in the databases MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus was performed through July 2020 by three independent reviewers. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. The pathogenesis remains controversial. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Epub 2011 Feb 18. It can cause pain and to a meniscal tear. The cause is not really known, but patients usually do not complain of instability. 5. What Is Mucoid Degeneration of the ACL? Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. In that case, mucoid degeneration can be extruded from the ligament and will be removed in the saline flow. what causes mucoid degeneration of acl. PMC https://doi.org/10.1016/j.jajs.2015.12.001, 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 rate of association between meniscal tears and MDACL ranged from 9 to 96%. J Orthop. Arthroscopically ACL is intact but fibrillated, yellowish and hypertrophied,with interspersed yellowish mucinous material along the fibers, lack of synovial linning of the ACL. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first described in the literature in 1999.1 Since then, MD-ACL has been recognized as a pathology present on between 0.7% and 5.3% of magnetic resonance images performed for knee pain.2 MD-ACL is thought to be part of a spectrum of ACL disease that can range from ganglion cysts to MD.3 MD-ACL can either be primary (idiopathic . Mucoid degeneration of ACL. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Epub 2021 Mar 8. Seventeen females (67%) and eight males (33%) were included in the final analysis. Postoperative pain relief was reported in seven studies. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. 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. Anterior cruciate ligament (ACL) mucoid degeneration, along with tears and anterior cruciate ligament ganglion cysts, is a relatively common cause of increased signal within the anterior cruciate ligament (ACL ). TS designed the project, literature search and wrote the manuscript. : A Meta-Analysis. MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. Symptomatic ACL mucoid degeneration in middle-age athletes. PubMed . A total of nine studies were eligible for review. Careers. Arthroscopic debridement of the ACL was the intervention in eight studies, whereas Morice et al. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Two patients uderwent secondary ligamentoplasty. Knee Surg Sports Traumatol Arthrosc. The .gov means its official. Pain was posterior in 23 knees (80%). Epub 2011 Feb 18. Morice et al. Mucoid degeneration of the anterior cruciate ligament. 2004;182(5):12831287. 2007;90(3):1923. Knee. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Mucoid degeneration of the anterior cruciate ligament. Pre-debridement arthroscopic view showing yellowish content in the anterior cruciate ligament. 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. All patients with a preoperative limited ROM (100%, n=9) reported a return to a normal (subjective) ROM. 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. 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. Anterior cruciate ligament mucoid degeneration. Unlike meniscal tears and chondral defects, the mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain and there have been no case reports of mucoid degeneration of both the ACL and the posterior cruciate ligament (PCL). Mucoid degeneration (MD) is a rare pathological affection of the anterior cruciate ligament (ACL). Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of knee pain. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. 2011. There is no consensus on treatment and evidence is scarce. Unable to load your collection due to an error, Unable to load your delegates due to an error. GG and AM interpreted the results and reviewed the manuscript. have described the following MRI criteria [4]: (1) high signal intensity in the T1 and T2 sequences, (2) increased ACL volume and (3) continuous fibres of ACL shown in the T2 sequence. The lesion may manifest as an elongated cyst along the long axis of the ACL, or as an enlarged ACL. What is Anterior Cruciate Ligament Mucoid Degeneration? This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Bookshelf Fig. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. Resnick D, Kransdorf MJ. Epub 2013 Aug 27. Method. Conclusions: Several authors have identified this condition, described their experiences, and suggested their own guidelines for management. mucoid degeneration acl symptoms. Does Femoral Intercondylar Notch Volume Differ in Anterior Cruciate Ligament-Injured Adult Patients Compared to the Uninjured? Anterior knee pain is the more common complaint. Kim TH, Lee DH, Lee SH, Kim JM, Kim CW, Bin SI. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a well-recognized pathology characterized by the degradation of collagen fibers and infiltration of a mucoidlike substance, [1,2 . official website and that any information you provide is encrypted Average improvement in flexion was 21.5 degrees (0 to 60 degrees). These appearances must be differentiated from mucoid degeneration of the intact ACL. Bethesda, MD 20894, Web Policies Clipboard, Search History, and several other advanced features are temporarily unavailable. Orthop Traumatol Surg Res. Manage cookies/Do not sell my data we use in the preference centre. Privacy First, our literature search revealed a heterogeneous group of studies dominated by case reports and case series, with no randomised controlled trials. Conclusions: Mucoid degeneration of the ACL is a clinical condition afflicting active middle-aged people without a single significant traumatic episode with a specific MRI picture. Therefore, Anterior Cruciate Ligament tear is more susceptible during any injury to the knee. https://doi.org/10.4103/0019-5413.101037, Srivastava A, Pateliya S, Singh H, Aggarwal S, Srivastava S (2016) Mucoid degeneration of anterior cruciate ligament management and functional outcome of 18 cases. Skeletal Radiol. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. sharing sensitive information, make sure youre on a federal Careers. This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features! The primary intervention was arthroscopic ACL debridement in eight studies; this was combined with notchplasty in cases of impingement with the lateral wall of the notch in five studies [6, 14, 16,17,18] (Table 3).