mucoid degeneration of acl physiotherapy

1). The origin of MDACL may be degenerative or traumatic. Pandey, Vivek et al. {"url":"/signup-modal-props.json?lang=us"}, Gaillard F, Roberts D, Saber M, et al. Online ahead of print. Morice et al. government site. Cite this article. The extracted data were heterogeneous in terms of outcome assessment. in 1999 [ 1 ]. Arthroscopic debridement of the mucoid degeneration of the ACL was safe and effective in the patient. Mucoid degeneration of the patellar ligament in athletes. It is a chronic degenerative change of a bulky ACL that may lead to notch impingement syndrome in the absence of instability symptoms and significant trauma history [ 1, 2, 3, 4 ]. and Ventura et al. Mucoid degeneration of the anterior cruciate ligament. Mucoid degeneration of the anterior cruciate ligament. 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. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. Please enable it to take advantage of the complete set of features! and transmitted securely. Knee Surg Sports Traumatol Arthrosc. 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. 8600 Rockville Pike J Knee Surg. Twenty knees (69%) had associated cartilaginous lesions and 19 (66%) had meniscal lesions. 2004;182 (5): 1283-7. 2021 Sep;50(9):1837-1843. doi: 10.1007/s00256-021-03750-7. Disclaimer. MAUDE Adverse Event Report: GENZYME BIOSURGERY (RIDGEFIELD) SYNVISC ONE [6], in 62% of patients (18 of 29) in the study of Lintz et al. Twelve partial and 17 total resections were performed. Cureus | Anterior Cruciate Ligament Ganglion Cyst and Mucoid 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 . With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. https://doi.org/10.1302/0301-620X.81B2.0810304, Article Keywords: JCM | Free Full-Text | Clinical Outcomes of Arthroscopic - MDPI 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. Methodological quality of the studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria [11] (Table1). The .gov means its official. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. This infiltrating lesion is included in the mucoid pathology of the intercondylar fossa. Arthroscopy. Its prevalence in magnetic resonance imaging (MRI) is 1.8 to 5.3%, but not all lesions are symptomatic. A long duration of non-specific knee pain in a patient should be evaluated with MRI. Epub 2011 Feb 18. Pain was posterior in 23 knees (80%). Clipboard, Search History, and several other advanced features are temporarily unavailable. 2011 Jun;25(6):650-2. Patients with symptomatic MDACL commonly present with posterior knee pain and limitation of knee flexion or extension [2, 6]. In the nine included studies, four different scores were used for outcome assessment. official website and that any information you provide is encrypted 1. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . This may support the theory that it is a degenerative process. Anterior cruciate ligament mucoid degeneration - Radiopaedia Mucoid degeneration of the anterior cruciate ligament - PubMed Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. Postoperative recovery was four weeks on average. The prevalence of mucoid degeneration of the ACL has been reported to be 0.43% [ 5 ]. Postoperative ACL laxity is a common finding after ACL arthroscopic debridement, however, symptomatic instability is not. Would you like email updates of new search results? Clipboard, Search History, and several other advanced features are temporarily unavailable. Both anterior cruciate ligament ganglion cysts and mucoid degeneration have a high association with intraosseous cysts [3] (figures 1 and 2). Sep 2017 - Feb 20186 months. Mucoid degeneration of the anterior cruciate ligament (ACL) is a rare cause of anterior knee pain (AKP). The cause is not really known, but patients usually do not complain of instability. Copyright 2010 Elsevier Masson SAS. Imaging: Plain radiographs 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. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. Sometimes, it is mislead as ACL tear on MRI findings, hence requires probing and histopathology for definitive diagnosis. The mean follow up ranged from 13 to 72months. Symptomatic ACL mucoid degeneration in middle-age athletes. Finally, partial meniscectomy was commonly performed simultaneously with ACL debridement in all studies, which arguably could be the reason for the postoperative improvement. Part of official website and that any information you provide is encrypted Young and active patients should be warned about the risk of requiring secondary ligamentoplasty. In most cases Physiopedia articles are a secondary source and so should not be used as references. 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. Arthroscopy 24(6):642649. Mucoid degeneration of the anterior cruciate ligament (MD-ACL) was first characterized by Kumar et al. 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. 2018 Jun;25(3):445-452. doi: 10.1016/j.knee.2018.02.012. 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]. This study concerns complete ACL resec Bethesda, MD 20894, Web Policies You can read more if you want. 2008 Jun;24(6):642-9. doi: 10.1016/j.arthro.2008.02.004. Tamer Sweed. 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). It results in postoperative laxity, but rarely in frank instability. I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Bergin D, Morrison WB, Carrino JA et-al. Postoperative pain relief ranged from 53.8 to 95%. International Journal of Orthopaedics. 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. Orthopaedics & Traumatology: Surgery & Research. Preoperative and postoperative KOOS questionnaires were compared and showed improvement in all categories. An official website of the United States government. MEDLINE, Embase, Google Scholar, Cochrane, ISI web of science and Scopus were comprehensively searched from the earliest year of indexing until 10 July 2020. -, McIntyre J, Moelleken S, Tirman P. Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears. Roberts CC, Towers JD, Spangehl MJ et-al. 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. Study record managers: refer to the Data Element Definitions if submitting registration or results information.. Search for terms https://doi.org/10.4103/0019-5413.128765, Article proposed a different intervention called reduction plasty, whereby the hypertrophic ACL is reduced to normal size without excision of all mucoid substance [17]. At the time the article was created Frank Gaillard had no recorded disclosures. 2022 Nov 24. doi: 10.1007/s00402-022-04659-z. Due to the heterogeneity of data, a meta-analysis was not possible, and a narrative review was deemed most appropriate. Introduction: Most authors believe that partial ACL resection is the treatment of choice in symptomatic MD of the ACL. Postoperative clinical laxity was common, however, symptomatic instability was not. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018087782. No reconstruction was performed at the same time. 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. . in 1999 [ 1 ]. https://doi.org/10.2214/ajr.182.5.1821283, Article 2004 Feb;20(2):141-6. doi: 10.1016/j.arthro.2003.11.030. Mucoid degeneration of the anterior cruciate ligament (ACL) is a very rare cause of knee pain. 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]. 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 However, in the case of mucoid degeneration secondary signs of an ACL injury are usually absent. Its interstitial nature within the ACL structure contrasts with synovial cyst of the ACL. MRI is better at detecting mucoid degeneration than arthroscopy, as the surface of the ligament is often intact. Cookies policy. [16]. Another theory is the synovial theory whereby a pouch of synovium herniates and is subsequently filled with synovium [2]. . 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. 1999;81(2):304305. eCollection 2013. Clinical significance of T2*-weighted gradient-echo MRI to monitor Results: Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. Anterior Cruciate Ligament, is an important structure of the knee joint. National Library of Medicine report that one patient had ACL reconstruction simultaneously after the ACL debridement. Epub 2011 Feb 18. HHS Vulnerability Disclosure, Help The extracted data were assessed for meta-analysis. Accessibility Epub 2013 Aug 27. 2010 Jun 1;96(4):400-6. Indian J Orthop 48(2):197202. FOIA 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. Generally, we know little about this condition. Intact fibers are best seen on T2WI. : A Meta-Analysis. 2008;24(6):642649. (10%) and highest in the study of Ventura et al. Association between magnetic resonance imaging characteristics and pathological findings in entire posterior cruciate ligament with mucoid degeneration. Physiotherapy. It can cause pain and to a meniscal tear. Instrumental treatment. 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. Typically patients present with knee pain or restricted movement, although often other potential causes for the patient's symptoms are found. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Oct;99(6):693-7. doi: 10.1016/j.otsr.2013.04.010. Bone and joint imaging. Sagittal T2-weighted MRI view showing intact anterior, Fig. 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. 2011;19(3):408411. Bookshelf Several critical distinctions allow a confident diagnosis of an ACL ganglion cyst. . Epub 2018 Aug 22. We herein describe a case of PCL mucoid degeneration presented with secondary ACL . [Diagnosis and treatment of anterior cruciate ligament cysts]. PROSPERO. 2 ). 2011 Aug;19(8):1326-33. doi: 10.1007/s00167-011-1433-0. Mucoid degeneration of the anterior cruciate ligament: Partial All nine included studies utilized MRI of the knee to establish a radiological diagnosis as an inclusion criterion. 3. Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. 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. The site is secure. Results: Hotchen AJ, Demetriou C, Edwards D, Melton JTK. sharing sensitive information, make sure youre on a federal Its signal is increased on all sequences. ANZ J Surg 73(9):712716. Knee Surg Sports Traumatol Arthrosc. See this image and copyright information in PMC. Arthroscopic treatment may include ACL resection, which raises the questions about the harmlessness of this procedure and the risk of anterior instability. Patients and methods: The https:// ensures that you are connecting to the All nine studies included patients with symptomatic MDACL confirmed by MRI (Table3). Answer (1 of 2): Most of the time mucoid degenrative changes in the ACL does not cause any problemonly if u have sign of ACL instability or the bending of the knee is reduced you may need a arthroscopic evaluation usually u may skip without ACL reconstruction but some of us will need AcL recons. Advanced MR imaging of the cruciate ligaments. Mucoid degeneration of the anterior cruciate ligament. The pathogenesis remains controversial. Mucoid degeneration of the anterior cruciate ligament: can platelet Characteristic: "celery stalk" appearance. Average improvement in flexion was 21.5 degrees (0 to 60 degrees). Functional Outcome of Arthroscopic Debridement of Mucoid Degeneration of the Anterior Cruciate Ligament. Seventeen females (67%) and eight males (33%) were included in the final analysis. 4. Before 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. eCollection 2021. Anterior cruciate ligament; Arthroscopy; Knee; Mucoid degeneration. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. All nine studies assessed the outcome of arthroscopic debridement of MDACL. Each study was scored 02 on each question, with a global ideal score of 16. Treatment modalities for ACL ganglion cyst include arthroscopic excision or puncture, CT scan, and ultrasound-guided aspiration [25-26]. All patients (100%, n=11) reported an improvement in pain. A 48-year-old-male patient presented with knee pain and limitation of motion. Due to the lack of specific symptoms and signs, its diagnosis is often delayed or even misdiagnosed in clinical practice [ [1] , [2] ]. Clin Orthop Surg. Introduction Mucoid degeneration of the anterior cruciate ligament (ACL) is a little-known pathology. -, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR. 2011 Mar;25(3):262-5. The retrospective study by Kim et al. None of the studies was a randomised controlled trial and none had a control group. Federal government websites often end in .gov or .mil. 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. Am J Roentgenol 182(5):12831287. Postoperative follow-up included standard radiography and dynamic examination, measuring laxity with a Telos device. -, 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. ACL MUCOID DEGENERATION RADIOLOGY MRI - Radedasia Arthroscopy 20(2):141146. NCI CPTC Antibody Characterization Program. Post-debridement arthroscopic view showing yellowish, Post-debridement arthroscopic view showing yellowish lesion of the anterior cruciate ligament which was, MeSH Seven of the nine studies reported using the Lachman test to check postoperative ACL laxity. W B Saunders Co. (2005) ISBN:0721602703. Knee Surg & Relat Res 33, 26 (2021). Shimasaki K, Yoshioka T, Kanamori A, Yamazaki M. Case Rep Orthop. Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament. Does mucoid degeneration of ACL require surgery? - TimesMojo Arthroscopic management of mucoid degeneration of anterior cru Introduction Mucoid degeneration of the anterior cruciate ligament (MDACL) is a rare entity, first described by Kumar et al. and transmitted securely. Google Scholar, Chudasama CH, Chudasama VC, Prabhakar MM (2012) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. Anterior cruciate ligament mucoid degeneration: MR findings Histological diagnosis was established by tissue biopsy in all patients in five studies, with a total of 87 knees. This study concerns complete ACL resection as a treatment of mucoid degenerated ACL. TS designed the project, literature search and wrote the manuscript. 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. Clipboard, Search History, and several other advanced features are temporarily unavailable. Please enable it to take advantage of the complete set of features! and transmitted securely. Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a The success of treatment for MDACL and the subsequent risk of instability is not known. 2022 Mar;14(1):76-89. doi: 10.4055/cios20163. Anterior cruciate ligament mucoid degeneration: Selecting the best Would you like email updates of new search results? eCollection 2022 May-Jun. 2. Coronal T2 weighted fat suppressed fast spin echo image showed complex anterior cruciate ligament ganglion cyst arising from superior aspect of ligament. Effects of pre-operative knee laxity on clinical outcomes after partial anterior cruciate ligament reconstruction. Mucoid degeneration of anterior cruciate ligament (ACL) Individuals with mucoid degeneration of the ACL were excluded. 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. Nowadays, orthobiologics such as platelet-rich plasma (PRP) are increasingly used in ligament surgeries to improve healing. Conclusions. I have persistent pain in the back of that knee that is exacerbated by walking and bending it. This was lowest in the study of Cha et al. Magn Reson Imaging Clin N Am. Knee Surgery, Sports Traumatology, Arthroscopy. [Effectiveness of bone-anterior cruciate ligament-bone allograft in reconstruction of anterior cruciate ligament under arthroscope]. Mucoid Degeneration Of Acl Treatment? The 140 Top Answers The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2022 Jun 2;20(1):225-228. doi: 10.33314/jnhrc.v20i01.4182. This ligament consists of two fibers, mainly, the anterio-medial and postero-lateral fibers, respectively. The https:// ensures that you are connecting to the The mean MINORS score was 9.5 (range 412). -Evaluated and planned treatment protocol in accordance with physician. Rajani AM, Shah UA, Mittal ARS, Gupta S, Garg R, Punamiya M. Knee Surg Relat Res. Conclusion: However, young patients should be forewarned about the risk of instability, and an anterior cruciate ligament reconstruction could be necessary. Arch Orthop Trauma Surg. Unable to load your collection due to an error, Unable to load your delegates due to an error. Anatomopathology samples were collected in 18 cases. (PDF) Assessment of imaging, pathoanatomy and - Academia.edu There was strong association between MDACL and chondral lesions (82%) and between MDACL and meniscal tears (69%). AJR Am J Roentgenol. 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). Epidemiology The likelihood of mucoid change within ligaments and tendons increases with age 1. Knee. The .gov means its official. Download Citation | On Feb 1, 2023, O.R. Epub 2013 Aug 27. (PDF) Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration Cho SD, Youm YS, Lee CC et-al. Arthroscopic treatment of mucoid degeneration of the anterior cruciate The authors declare that they have no competing interests. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. 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. Epub 2010 May 8. Please enable it to take advantage of the complete set of features! Google Scholar, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P (2010) Anterior cruciate ligament mucoid degeneration: selecting the best treatment option. Dietary management and various treatments Scanning and diagnostic . Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. Epub 2021 Mar 8. Anterior knee pain is the more common complaint. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. The origin of MDACL may be degenerative or traumatic. 2006 Sep;69(9):449-52. doi: 10.1016/S1726-4901(09)70290-4. Anterior cruciate ligament mucoid degeneration: selecting the best Knee Surg Sports Traumatol Arthrosc. Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. Unable to load your collection due to an error, Unable to load your delegates due to an error. In the Lintz study, total resection of the ACL was performed in 17 out of 29 knees, while in the Ventura study total resection was performed in 17 out of 25 patients. . -, Fealy S, Kenter K, Dines JS, Warren RF. https://doi.org/10.1016/j.jclinepi.2009.06.005. JBR-BTR. J Arthrosc Joint Surg 3(1):2833. Radiologic findings associated with mucoid degeneration of the anterior cruciate ligament. PDF Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration: A Review Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Two patients uderwent secondary ligamentoplasty. 287 (3): 912-921. -, Makino A, Pascual-Garrido C, Rolon A, Isola M, Muscolo DL. official website and that any information you provide is encrypted Unauthorized use of these marks is strictly prohibited. Data extracted included mean age and gender of the patients, duration of follow up, associated chondral and meniscal lesions, interventions and outcomes. The quality of methodology was excellent in one study, good in five studies, low in two studies and very low in one study (Tables 1 and 2). 2021 Aug 21;33(1):26. doi: 10.1186/s43019-021-00110-6. CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported. MUCOID DEGENERATION OF ACL - ARTHROSCOPIC TREATMENT - YouTube KoreaMed Synapse 2013 Jun 20;15:59. doi: 10.11604/pamj.2013.15.59.2534. Mucoid degeneration of the anterior cruciate ligament is a rare pathological entity. Only nine studies met our inclusion criteria and they were all case series. ACL tears don't heal as such. However, the authors did not report whether there were any other patients with symptomatic instability. Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D. Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Bergin et al. government site. Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P. Orthop Traumatol Surg Res. However, symptomatic instability was not common. How is mucoid degeneration treated? - Sdnimik.bluejeanblues.net Accessed 1 Mar 2021. Patient having mucoid degeneration of ACL seeks multiple orthopedic consultation and most of the time treating orthopedican miss its diagnosis either because of lack of experience or rare cause of pain unless doctor sought magnetic resonance imaging (MRI) of knee. Ligaments are very tough, fibrous tissue structures. Terms and Conditions, Rehabilitation, orthophony, crenotherapy. 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. Second, methodological quality assessment showed that three studies had low methodological quality. ACL (anterior cruciate ligament) mucoid degeneration means the lesion of the ACL. 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).

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