Mucoid degeneration of the anterior cruciate ligament: Management and outcome.. Generally, we know little about this condition. IV (retrospective cohort study). Please enable it to take advantage of the complete set of features! J Orthop. -osis is a suffix denoting a process, condition, or state, the histology of the Achilles tendon and in ACL injuries(24-26). Knee Surgery, Sports Traumatology, Arthroscopy. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Clipboard, Search History, and several other advanced features are temporarily unavailable. Diet therapy and various other treatments (general aspects) Discipline Radiotherapy. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Methods From January 2012 to August 2013, 32 knees (24 females and 8 males with left knee of 14 and 18 of right) were diagnosed with mucoid degeneration of the ACL and underwent arthroscopic treatment, all of whom with a mean age of 58.817.97 years (42-74 years). National Library of Medicine Score: 4.7/5 (45 votes) . Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. https://doi.org/10.4103/0019-5413.128765, Article Arch Orthop Trauma Surg. Anatomopathology samples were collected in 18 cases. All patients (100%, n=11) reported an improvement in pain. Skeletal Radiol. The anterior cruciate ligament (ACL) is one of the more vital and more easily injured ligaments within our knee. 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. The .gov means its official. MDACL is diagnosed by MRI, showing a celery stalk sign, and is confirmed by tissue biopsy and histological examination [7]. 1999;81(2):304305. Hypothesis: In these studies, the total number of patients with a postoperative positive Lachman test was 40% (77 of 194 patients). Management of mucoid degeneration of the anterior cruciate ligament: a systematic . Methods: The minimum follow-up was 3 years. ANZ J Surg 73(9):712716. Accessed 1 Mar 2021. The ligament is mainly responsible for restraining anterior translation of knee. Knee Surg Sports Traumatol Arthrosc. 1). California Privacy Statement, Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. 1. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms However, the authors did not report whether there were any other patients with symptomatic instability. PMC Disclaimer. Terms and Conditions, 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. This was lowest in the study of Cha et al. 287 (3): 912-921. Possible etiologies include: It is postulated that mucoid degeneration may be a predisposing factor in the formation of ACL ganglion cysts. NCI CPTC Antibody Characterization Program. Mucoid degeneration of the anterior cruciate ligament: a case report. Please enable it to take advantage of the complete set of features! official website and that any information you provide is encrypted Seventeen females (67%) and eight males (33%) were included in the final analysis. 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. Introduction: 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]. International Journal of Orthopaedics. volume33, Articlenumber:26 (2021) Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). FOIA . The .gov means its official. The appearance can mimic acute or chronic interstitial partial tears of the ACL. Bergin D, Morrison WB, Carrino JA et-al. The extracted data were heterogeneous in terms of outcome assessment. A 48-year-old-male patient presented with knee pain and limitation of motion. https://doi.org/10.1016/j.jclinepi.2009.06.005. 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. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 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. 2009 Jul;17(7):737-40. doi: 10.1007/s00167-008-0690-z. Level of evidence: MDACL is not uncommon, however, it is rarely symptomatic [4, 5]. This site needs JavaScript to work properly. Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. and transmitted securely. Read More Created for people with ongoing healthcare needs but benefits everyone. Arthroscopy. The aetiology of MDACL is not clearly understood. 2018;4(4):875-80. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. government site. 1 Its prevalence in magnetic resonance imaging (MRI) is 1.8-5.3%, but not all lesions are symptomatic.2, 3 It is characterized by infiltration of mucoid-like substance (glycosaminoglycans) interspersed within the Before The total number of patients with symptomatic instability was 18 out of 288 (6%). Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. Bookshelf The appearance can mimic acute or chronic interstitial partial tears of the ACL. 2007;90(3):1923. This site needs JavaScript to work properly. Anterior cruciate ligament ganglia and mucoid degeneration: Coexistence and clinical correlation. Reeducation. 3. 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. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Federal government websites often end in .gov or .mil. Exclusion criteria were (1) case reports, literature reviews and conference abstracts and (2) studies written in languages other than English. Unauthorized use of these marks is strictly prohibited. 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. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Tissue biopsy was performed in 85% of patients (58 of 68) in the study of Cha et al. Disclaimer. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. In contrast to the tear, mucoid degeneration of the ACL characteristically does not cause knee instability [20, 21, 22]. A positive Lachman test and a negative pivot shift were noted after surgery in all cases. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. The mean age at the time of surgery was 57 years (range, 31 to 78 years). ACL tears don't heal as such. Arthroscopy. sharing sensitive information, make sure youre on a federal Mucoid degeneration of the ACL is suspected when an apparently thickened and ill-defined ligament with increased signal intensity on all sequences in MRI is identified in a patient with physically intact ligament and no obvious trauma history. Preoperative magnetic resonance imaging (MRI), Fig. report that one patient had ACL reconstruction simultaneously after the ACL debridement. They respond well to a judicious arthroscopic release of the ACL with notchplasty. Knee Surg Sports Traumatol Arthrosc. Orthopaedics & Traumatology: Surgery & Research. 2013;15(1). Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). 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. The cause is not really known, but patients usually do not complain of instability. All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. Advanced MR imaging of the cruciate ligaments. 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Partial resection of the anterior cruciate ligament was done in seven cases and a complete resection in 18 cases. There was strong association with chondral lesions and meniscal tears. What you feel (symptoms) You feel heaviness in knee joint. Preoperative magnetic resonance imaging (MRI) scan. The mean age of patients ranged from 31 to 78years. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. ADVERTISEMENT: Supporters see fewer/no ads. However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Cite this article. Epub 2018 Apr 21. Loss to follow up was not mentioned in the other five studies [3, 6, 15, 17, 19]. Cookies policy. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. By using this website, you agree to our There was no mention in the other three studies [13, 15, 18] of whether other procedures were performed simultaneously. Therefore, indications for ACL resection must be carefully selected. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Unable to load your collection due to an error, Unable to load your delegates due to an error. Three reviewers (an experienced librarian and two of the authors) independently searched these databases. Pan African Medical Journal. Arthroscopic debridement may help relieve the anterior knee pain. 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). This is a rare pathological condition, in which, there is increased signal from within the ligament. 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]. Chudasama et al. (A) Bulging of, Fig. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Epub 2008 Dec 17. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament. Federal government websites often end in .gov or .mil. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Mucoid degeneration of the anterior cruciate ligament. Palmer W, Bancroft L, Bonar F, Choi JA, Cotten A, Griffith JF, Robinson P, Pfirrmann CW. Mucoid degeneration (MD) of the anterior cruciate ligament (ACL) is a rare pathological entity with disputed theories of origin. This makes it difficult to relate the improvement of symptoms to ACL debridement. Arthroscopic debridement of the anterior cruciate ligament (ACL) results in satisfactory pain relief and improvement in knee outcome scores. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. 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. 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Bookshelf Sagittal T2-weighted MRI view showing intact anterior, Fig. The aetiology of MDACL is not fully understood, hence, there are multiple theories on this. Four studies reported only postoperative scores, which were comparable to those in other studies. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Knee Surg Sports Traumatol Arthrosc. Case report: 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). #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. Anterior Cruciate Ligament (ACL) Mucoid Degeneration Anatomy Anterior Cruciate Ligament, is an important structure of the knee joint. 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). Keywords: mucoid degeneration, anterior cruciate ligament, acl reconstruction, arthroscopy, knee "Traumatic theory - post injury, ACL fibroblasts secrete glycosaminoglycans, the mucin substance within the ACL. Epub 2018 Jun 13. 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. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. and transmitted securely. and transmitted securely. However, MDACL is asymptomatic in most patients. Risk factors Predisposing factors include the following 1: aging The https:// ensures that you are connecting to the 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. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. PubMed The author(s) read and approved the final manuscript. Federal government websites often end in .gov or .mil. Methods: The mean MINORS score was 9.5 out of 16 (412). Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. 2011 Mar;25(3):262-5. Please enable it to take advantage of the complete set of features! Partial/Total ACL resection arthroscopically- There is marked improvement in the range and reduced posterior pain, but at the cost of increased post-operative knee laxity. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. ACL ganglion cyst at arthroscopy may appear as a cystic mass with . -, Hensen JJ, Coerkamp EG, Bloem JL, De Schepper AM. 2011 Aug 1;19(8):1326-33. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series. PMC Epub 2021 Nov 24. Categories were determined in accordance with the study of Ekhtiari et al. Arthroscopy. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. 2022 Apr 11;31:67-71. doi: 10.1016/j.jor.2022.04.004. 2011. el Kadi KI, Marcaillou F, Blanc S, Salloum B, Dimontagliari C, Boutayeb F. Pan Afr Med J. Part of https://doi.org/10.1007/s00167-012-1991-9, McIntyre J, Moelleken S, Tirman P (2001) Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. (A) Bulging of the hypertrophied anterior cruciate ligament. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The clinical presentation is one of posterior pain with limited flexion. 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). government site. . Indian J Orthop. Postoperative clinical laxity was common, however, symptomatic instability was not. Twelve partial and 17 total resections were performed. Preoperative and postoperative results of eleven patient were compared. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. sharing sensitive information, make sure youre on a federal ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. 1173185. Symptomatic ACL mucoid degeneration in middle-age athletes. 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. Mucoid degeneration of the ACL is suspected when an apparently thickened and ill-defined ligament with increased signal intensity on all sequences in MRI is identified in a patient with physically intact ligament and no obvious trauma history. [16]. Indian J Orthop 46(5):561565. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Mucoid degeneration,: like degenerative arthritis of a joint, generally occurs as a results of aging. Posterior pain disappeared in 27 cases (93%), on average 3.7 weeks after the procedure. mucoid degeneration acl symptoms. in 1999 [ 1 ]. The rate of simultaneous meniscectomy ranged from 13 to 44%. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Instrumental treatment. Average postoperative differential laxity on the Telos device was 8.3 mm (5 to 13 mm). The rate of association between meniscal tears and MDACL ranged from 9 to 96%. This study hypothesized that arthroscopic debridement of MDACL would provide patients with improvement in pain, range of movement and functional outcome scores. Arthroscopic diagnostic criteria [7] are (1) continuous ACL fibres, (2) increased ACL volume, (3) yellowish-coloured material expressed on palpation and (4) loss of ACL synovial lining. AJR Am J Roentgenol. Postoperative symptomatic instability was not common in eight studies, but was observed in 48% of patients in the study of Lintz et al., with two patients having a delayed ACL reconstruction. 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]. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Download Citation | On Feb 1, 2023, O.R. (48.2% (14/29 patients) with symptomatic instability), which may be due to the large number of patients with total resection of the ACL (58.6% (17 out of 29 patients)) (Table 4). ACL debridement was partial in all studies except for those by Lintz et al. Clin Orthop Surg. The purpose of this study was to investigate the outcome of management of MDACL by performing a systematic review of methods of treatment that have been reported. An official website of the United States government. PubMedGoogle Scholar. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH Roberts CC, Towers JD, Spangehl MJ et-al. Keywords: 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 . Keywords: HHS Vulnerability Disclosure, Help sharing sensitive information, make sure youre on a federal proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. Unauthorized use of these marks is strictly prohibited. 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. . Manage cookies/Do not sell my data we use in the preference centre. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. Discussion: 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). -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Imaging: Plain radiographs Level of Evidence: Level IV. To our knowledge, this is the first systematic review to look into the results of the management of MDACL. 8600 Rockville Pike Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Results: 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. -, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Eight patients (72.7%, n=8) reported an improvement of knee instability, while three patients (27.3%, n=3) experienced an unchanged knee stability. Unauthorized use of these marks is strictly prohibited. Glossary of terms for musculoskeletal radiology. . Secondary signs include bone bruising, meniscal tears, anterior subluxation of the tibia and other ligamentous injuries. Unable to load your collection due to an error, Unable to load your delegates due to an error. 2011. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. 5. 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. AJR Am J Roentgenol. When refering to evidence in academic writing, you should always try to reference the primary (original) source. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. in 1999 [1]. MM and A performed the literature search, and data analysis. Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. 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. Patients will . What causes mucoid degeneration of ACL? Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. -, Fealy S, Kenter K, Dines JS, Warren RF. Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Sep 2017 - Feb 20186 months. Epub 2011 Feb 18. Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A. Knee Surg Relat Res. The aim of this study was to detail the clinical, radiological, arthroscopic, and pathological findings of mucoid degeneration of the anterior cruciate ligament and report the clinical outcomes following arthroscopic treatment. None of the studies was a randomised controlled trial and none had a control group. Bergin et al. Bergin et al. Online ahead of print. Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Second, methodological quality assessment showed that three studies had low methodological quality. On MRI, the ligament is thickened and ill-defined with a "celery stalk" appearance. Arthroscopic findings. This site needs JavaScript to work properly. We report a case of mucoid degeneration of the ACL in a 50-year-old female with knee pain of 18 months duration. The https:// ensures that you are connecting to the . Average improvement in flexion was 21.5 degrees (0 to 60 degrees). 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. Epub 2011 Feb 18. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. Only three studies mentioned failed conservative treatment as an inclusion criterion [14, 15, 18]. : A Meta-Analysis. Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. In this systematic review we found that arthroscopic debridement resulted in good pain relief and improved range of motion and clinical outcome scores. reported on the co-existence of mucoid degeneration and ganglia of the ACL. Patients in all studies presented with central or posterior knee pain, mainly with terminal extension in three studies [14, 16, 17]. Loganathan D, Soma Sundar S, Sundar S, Sahanand S, Rajan DV. This appearance can mimic acute or chronic interstitial partial tears of the ligament. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). Instrumental treatment. J Sports Med Phys Fitness 48(4):483487, PubMed Conclusions: (Table 3). 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). 2004;182 (5): 1283-7. This study was registered on PROSPERO [10], an international prospective register of systematic reviews (CRD42018087782).
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