It can be secondary to trauma, or simply degeneration caused by meniscal injury, osteoarthritis or chondral damage [2]. Instrumental treatment. https://doi.org/10.1302/0301-620X.81B2.0810304, Article Friends. mucoid degeneration acl symptoms. Mucoid degeneration of the anterior cruciate ligament (ACL) of the knee can cause knee pain and other symptoms. If left untreated, a small ACL tear will increase in size, causing more pain and increasing the laxity in the knee. As we age, the connections between the collagen fibers that make up the meniscus begin to deteriorate, causing failure of the structure and tears due to stresses in the joint. Your surgeon will use a piece of tendon from another part of your knee or a tendon from a deceased donor. Since the ACL is an extrasynovial structure, irritation or trauma to the synovium covering the ACL may initiate the release of hyaluronic acid and the production of mucin causing the development of a ganglion cyst within or adjacent to the cruciate ligament . 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. 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). Inclusion criteria was as follows: (1) clinicoradiological confirmation of MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee joint; (2) patients with less than 10 of varus or 5 of valgus deformity and (3) patients with no flexion contracture. Treatment Notes prior to January 29, 2019 . Finally, the patients who underwent debulking had a better mean subjective patient satisfaction (9.830.37 versus 8.680.71) at the final follow-up at 2years (p<0.05) (Table 2). Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username, Additional Professor, Department of Orthopaedics, AIIMS Jodhpur, Jodhpur, Rajasthan, 342005, India, Senior Resident, Department of Orthopaedics, AIIMS Jodhpur, Jodhpur, Rajasthan, 342005, India. Pre-operatively, patients were examined and clinicoradiologically confirmed for MD-ACL and medial compartment osteoarthritis (MCOA) of the affected knee. You may also wear a brace to stabilize your knee and use crutches for a while to avoid putting weight on your knee. Others may make an appointment with their family doctors. (i.e., thinning or thickening) or signs of ligament degeneration and attrition such as mucoid degeneration or sclerosis were absent in all specimens. Let others know if this answer was helpful Predetermined inclusion and exclusion criteria were used for sample collection. These cysts have a variable MR appearance and are not always confined to the substance of the ligament. At arthroscopy, the ACL appeared homogenous, bulbous, and hypertrophied in all patients. The abnormal sliding within the knee also can hurt cartilage. Go to the Bones, Joints & Muscles Support Group. Why Do Cross Country Runners Have Skinny Legs? As per study population statistics, the prevalence of medial meniscus tears (29.64%) in this study were congruent to the rates found in studies by Srivastava etal. An ACL sprain is when the ACL is overstretched (but not torn). Physiotherapy and yoga based exercises will help you. Sports medicine & outpatient orthopedics. After a database search of 4,221 knee MRI examinations, Bergin et al. An ACL sprain is when the ACL is overstretched (but not torn). Amyn M. Rajani. The cruciate ligaments control the back and forth motion of your knee. What is mucoid degeneration of the meniscus? Journal of the American Academy of Orthopaedic Surgeons. : any of various mucoproteins that occur especially in secretions of mucous membranes. Anterior Cruciate Ligament, is an important structure of the knee joint. Stability of the joint is not compromised on controlled debulking. Mucoid degeneration of anterior cruciate ligament (ACL). However, upon following-up with these patients, and gauging their clinical and functional parameters, complaints of rest pain and restriction of terminal flexion seemed to persist. Diagnosis is usually made on the MRI. Reactive marrow edema (arrowheads) surrounds the intraosseous ganglia. Ganglion cysts are filled with gelatinous and viscous fluid in the neighbourhood of joints or tendon sheaths. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. The appearance can mimic acute or chronic interstitial partial tears of the ACL. https://doi.org/10.3109/17453679209154722, Gibson PH, Goodfellow JW (1986) Stress radiography in degenerative arthritis of the knee. Lachmans test was performed intra-operatively in the immediate aftermath of the debulking, and only 27 (11.95%) knees were found to have grade one laxity with a firm end point, while no laxity was noted in the other knees. What is the meaning of mucoid degeneration? The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. Knee Surgery & Related Research These patients were included in group A (na=216). Sixty-one patients underwent T2*WI and PDWI at 3, 6, and 12 months postoperatively. Rehabilitation, speech therapy, crenotherapy. 6 Antonacci VP, Foster T, Fenlon H, Harper K, Eustace S: Technical report: CT-guided aspiration of anterior cruciate ligament ganglion cysts. 2001. [22], Pandey etal. INTRODUCTION 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 . In vivo elongation of the anterior cruciate ligament and posterior cruciate ligament during knee flexion. 1998 Oct;53(10):771-3. Management of mucoid degeneration of the anterior cruciate ligament: a systematic . There's no set time frame for athletes to return to play. This course of physical therapy may successfully treat an ACL injury for individuals who are relatively inactive, engage in moderate exercise and recreational activities, or play sports that put less stress on the knees. Correlations between degree of knee instability and SIR were assessed for each bundle, each time point, and each sequence. fibroid degeneration degeneration of a leiomyoma with subsequent fibrosis. The scores were then compiled and statistically analysed using SPSS-24 software to understand if the debulking resulted in any significant difference in the outcomes. Sagittal T1-weighted (1a) and fat-suppressed proton density-weighted (1b) images. Autologous PRP, prepared by double spin protocol, was injected into the remaining ACL after partial debridement was done. Paterno MV, et al. On physical exam, the Lachman test for ACL instability is negative with an ACL ganglion. customer@scirp.org +86 18163351462(WhatsApp) statement and (Tr. These patients who underwent UKA with debulking of MD-ACL were included in group B (nb=226). https://orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/. Int J Curr Res Acad Rev 4(11):1824. Close. anterior cruciate ligament mucoid degeneration; mucoid degeneration of the triangular . Once considered a rare disease, it is probably a less diagnosed condition of knee pain. Among other conditions - osteoarthritis, osteopenia, spondylolisthesis- an MRI report showed "severe mucoid degeneration of the ACL" in my left knee. A surgical procedure that involves replacing a damaged, worn or diseased knee with an artificial joint to restore knees movement. the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. Investigation, data curation, validation, writing original draft was done by U.S., A.M., S.G. and R.G. ACL Injury Grades. Anterior knee pain is the more common complaint. However, in the case of mucoid degeneration . mucoid degeneration of acl mri. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. They were segregated into two groups matched for all demographic and pre-operative values: group A did not undergo debulking; group B underwent open debulking by a 15-number blade prior to UKA. It may lead to knee pain. [7] have documented the presence of flexion contracture, we did not notice the same in any patient from the recruited sample size. 1st ed. PubMed Central This was postulated to be due to the increased tension caused by the mucinous deposition in the substance of the ACL, leading to irritation of the native nociceptors of the tendon and the consequent impingement on the lateral femoral condyle, femoral notch and posterior cruciate ligament (PCL) owing to the increased thickness of the ACL [6,7,8]. If your activities do not involve making pivoting movements on the knee, physical therapy rehabilitation may be all you need. All the patients were operated on in a leg hanging position and under tourniquet control. Such meniscal tears are not appropriate for repair most of the time (Fig. volume34, Articlenumber:40 (2022) Arthroscopic debridement may help relieve the anterior knee pain. Plain radiographs of all the patients taken in anteroposterior and lateral views (in standing) at 2years follow-up showed no signs of implant failure in any patient. The ligament can also tear due to work injuries or automobile accidents. 1998-2023 Mayo Foundation for Medical Education and Research. But full ACL tears cannot be healed without surgery. Knee Surg Relat Res 33(1):26. https://doi.org/10.1186/s43019-021-00110-6, Kennedy JA, Mohammad HR, Mellon SJ, Dodd CAF, Murray DW (2020) Age stratified, matched comparison of unicompartmental and total knee replacement. (2a) T1-weighted sagittal image demonstrates an enlarged, club-shaped anterior cruciate ligament (arrows). cystic degeneration degeneration with formation of cysts. : tissue degeneration marked by conversion of cell substance into a glutinous substance like mucus. CAS Hence, the improvement in ROM, attenuation of rest pain and better long term functional outcome measures supported the hypothesis regarding the positive effect of debulking a MD-ACL in patients undergoing UKA. K Munde: Substantial contributions to the design of the work, analysis of the data for work, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The power of the study for the corrected model was estimated to be 92% for the aforementioned sample size when keeping the value of as 0.05, the degree of freedom (df) as 1, and adjusted R2 as 0.023. Flag this answer. Culmination of these results meant that even the patient satisfaction at 2years follow-up was better in the debulking group. 3, 2018 www.ecios.org Mucoid degeneration (MD . Anyone else have this and how was it treated if at all? CAS Am J . Without a properly functioning ACL, the other structures of the knee experience greater strain, which causes further injuries to tissues in the knee. These include pristine lateral and patellofemoral compartments, correctable varus deformity, less than 1015 of fixed flexion deformity, flexion of more than 100, and functionally intact collateral ligaments and cruciates [10,11,12,13,14,15]. To provide the highest quality clinical and technology services to customers and patients, in the spirit of continuous improvement and innovation. Patient is advised to do exercises to get movement and strength again following surgery. Voxel numbers of . In: Current Medical Diagnosis & Treatment 2019. 2). On table, the extent of impingement caused by the mucoid degeneration was gauged using an arthroscopy hook. . c End-point of debulking when the surgeon can pass the arthroscopy hook between the medial cortex of lateral femoral condyle and lateral border of the native ACL effortlessly. By a paramedian incision and mini-midvastus arthrotomy, the joint was exposed. . We believe that meniscal mucoid degeneration with tear is not uncommon. The severity of the ACL injury is graded from 1 to 3. The purpose of this study was to diagnose mucoid degeneration of anterior cruciate ligament and to assess the effectiveness of arthroscopic treatment in these patients.Materials and MethodsBetween December 2007 and November 2011, 20 patients were diagnosed to be suffering from mucoid degeneration of anterior cruciate ligament (ACL) on the basis . Treatment: For symptomatic knees surgical debulking /debridement in which thickened part of the ACL is shaved . Subsequently, the final sample included 442 patients who were followed-up for at least 2years after surgery (Fig. Despite integrity and status of cruciates being paramount in a UKA, no study has evaluated the effect of debulking MD-ACL in this procedure. Truncation means that the . They were however, supplemented by other objective methods such as comparison of pre-operative, post-operative and follow-up status of lateral view of plain radiograph in standing position, to look for any posterior translation of the femur which would suggest instability. Clin Orthop Relat Res 248:1314, Hotchen AJ, Melton JTK (2018) Radiofrequency ablation for mucoid degeneration of the anterior cruciate ligament. Accessed Nov. 21, 2018. J Arthosc 6:322, 1990. on nine studies [8]. in this condition your acl (anterior cruciate ligament) filled with jelly like material and it thickened so space in intercondylar resion of knee joint is reduced. Mucoid degeneration of the anterior cruciate ligament (ACL) is a common pathology but is often unknown and underdiagnosed. Debulking of mucoid ACL in patients undergoing unicompartmental knee arthroplasty significantly reduces the rest pain and improves the final range of motion of the knee joint, subsequently improving the overall functional and clinical outcome of the patient and resulting in greater patient satisfaction. DOI: 10.1016/J.JAJS.2015.12.001 Corpus ID: 74774556; Mucoid degeneration of the anterior cruciate ligament: Partial arthroscopic debridement and outcomes @article{Khanna2016MucoidDO, title={Mucoid degeneration of the anterior cruciate ligament: Partial arthroscopic debridement and outcomes}, author={Gagan Khanna and Rajan Sharma and Aditya Bhardwaj and Harjot S. Gurdutta and Deepak Agrawal and . Every time when patient flexes the knee, thickened ACL impinges over posterior cruciate ligament (PCL) in the knee, causing knee pain and limited motion. 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 . Although a few studies such as the one by Lee etal. Do any specific movements seem to improve or worsen your symptoms? The patients clinical history and symptoms do not support an ACL injury. What happens if a torn ACL goes untreated? The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Rehabilitation, orthophony, crenotherapy. It is a very rare cause of knee pain and can be diagnosed preoperatively on MRI. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. Corroborating these findings were the improvements and the final PROMs of both the groups which corresponded with the findings of the literature review by Sweed etal. Anterior cruciate ligament (ACL) injury.Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018. Subsequently, controlled debulking of the posterolateral fibers was done using a 15-number blade until it was possible to tug at the ACL by passing a hook between the lateral femoral condyle and the posterolateral fibres of the ACL (Fig. PubMed et al. https://doi.org/10.1186/s43019-022-00169-9, DOI: https://doi.org/10.1186/s43019-022-00169-9. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). MD-ACL lies in the grey area of a stable, yet functionally limiting condition that has the propensity to become relatively unstable after undergoing debulking. A case of mucoid degeneration of the anterior cruciate ligament (ACL) is reported based on specific imaging features on MRI. Justamom21. It is characterized by infiltration of mucoid like substance (glycosaminoglycans) interspersed within the substance of ACL causing knee pain and limited motion. The portal can access those files and use them to remember the user's data, such as their chosen settings (screen view, interface language, etc. When a cruciate ligament ganglion is discovered incidentally, no intervention is necessary. This study used PRP to augment the weakened ACL and followed patients for 1 year to assess outcomes. Treatment: For symptomatic knees surgical debulking /debridement in which thickened part of the ACL is shaved off, is the treatment of choice. Incidence of second ACL injuries 2 years after primary ACL reconstruction and return to sport. 3). Do Men Still Wear Button Holes At Weddings? Connect with thousands of patients and caregivers for support, practical information, and answers. Generally, we know little about this condition. Friedberg RP. What is your diagnosis? In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years. On inter-group comparison, VAS score for rest pain of the debulking group (0.130.46) was also found to be lower than the non-debulking group (2.640.95) (p<0.05). Complete your request online or contact us by phone. [5]. Grade 1A laxity on Lachmans test (less than 5mm translation with a firm end-point) was noted in 27 knees (11.95%) intra-operatively in group B or those who underwent debulking (nb=226), whereas a firm endpoint with no translation was noted in all of the remaining 199 knees (88.05%). Ever since mucoid degeneration of the anterior cruciate ligament (MD-ACL) was named by Kumar etal. Enter your email address below and we will send you the reset instructions. J Bone Jt Surg Ser B 81(2):304305. Hence, we targeted a minimum sample size of 400 patients. By continuing to browse this site, you accept our, International Journal of Endocrine Oncology, International Journal of Hematologic Oncology, Reduction plasty for hypertrophic anterior cruciate ligament mucoid degeneration: clinical and knee laxity outcomes in 23 cases, Salvati F, Rossi F, Limbucci N, Pistoia ML, Barile A, Masciocchi C, Mucoid metaplastic-degeneration of anterior cruciate ligament, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR, Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation, Makino A, Pascual-Garrido C, Roln A, Isola M, Muscolo DL, Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK, Mucoid cystic degeneration of the cruciate ligament, Mucoid degeneration of the anterior cruciate ligament, Arthroscopic management of mucoid degeneration of anterior cruciate ligament, Pandey V, Suman C, Sharma S, Rao S, Kiran Acharya K, Sambaji C, Mucoid degeneration of the anterior cruciate ligament: management and outcome, Mucoid degeneration of the anterior cruciate ligament: a case report and review of literature, 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, Ventura D, Nuez JH, Joshi-Jubert N, Castellet E, Minguell J, Outcome of arthroscopic treatment of mucoid degeneration of the anterior cruciate ligament, Kim T-H, Lee D-H, Lee S-H, Kim J-M, Kim C-W, Bin S-I, Arthroscopic treatment of mucoid hypertrophy of the anterior cruciate ligament, Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA, Platelet-rich plasma: from basic science to clinical applications, Southworth T, Naveen N, Tauro T, Leong N, Cole B, The use of platelet-rich plasma in symptomatic knee osteoarthritis, Vogrin M, Rupreht M, Crnjac A, Dinevski D, Krajnc Z, Renik G, The effect of platelet-derived growth factors on knee stability after anterior cruciate ligament reconstruction: a prospective randomized clinical study, Partial anterior cruciate ligament ruptures: advantages by intraligament autologous conditioned plasma injection and healing response technique midterm outcome evaluation, Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears, Rating systems in the evaluation of knee ligament injuries, Hensen JJ, Coerkamp EG, Bloem JL, Schepper AMD, Association of mucoid degeneration of anterior cruciate ligament with knee meniscal and cartilage damage, Lintz F, Pujol N, Dejour D, Boisrenoult P, Beaufils P, Anterior cruciate ligament mucoid degeneration: selecting the best treatment option, Zicaro JP, Yacuzzi C, Garcia-Mansilla I, Costa-Paz M, Nonsurgical treatment of partial ACL tears: intraarticular injection of platelet-rich plasma did not change the progression rate to knee instability, Seijas R, Ares O, Cusc X, lvarez P, Steinbacher G, Cugat R, Partial anterior cruciate ligament tears treated with intraligamentary plasma rich in growth factors, Long-term outcomes of primary repair of the anterior cruciate ligament combined with biologic healing augmentation to treat incomplete tears, McRobb J, Kamil KH, Ahmed I, Dhaif F, Metcalfe A, Influence of platelet-rich plasma (PRP) analogues on healing and clinical outcomes following anterior cruciate ligament (ACL) reconstructive surgery: a systematic review. These appearances must be differentiated from mucoid degeneration of the intact ACL. Common wrist ganglions include: dorsal wrist ganglion volar wrist ganglion volar retinaculum ganglion extensor retinaculum ganglion occult ganglion intraosseous ganglion mucous cyst In a 2007 study of patients in Glasgow whose foot lumps were removed surgically, 39 of 101 cases were ganglion cysts. Scribd adalah situs bacaan dan penerbitan sosial terbesar di dunia. https://doi.org/10.1177/03635465010290051301, Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case series. ), or their login data. Mumbai, Maharashtra, India. Usually there is no history of any significant trauma. Arthrosc Tech 7(5):e459e463. 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 ). Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is commonly treated with arthroscopic debridement of the ACL. Google Scholar, Bergin D, Morrison WB, Carrino JA, Nallamshetty SN, Bartolozzi AR (2004) Anterior cruciate ligament ganglia and mucoid degeneration: coexistence and clinical correlation. was the primary surgeon and was responsible for the conceptualization, methodology, supervision, writing review and editing. 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. Plain radiographs in lateral view (in standing) of the left knee of patient number 164 from group B (Left to Right): a Pre-operative radiograph for baseline position of posterior femur and tibia. With cruciate ligament ganglia, intact ACL fibers can often be visualized coursing through or around the cyst. Knee Surg Sports Traumatol Arthrosc 21(3):658663. Mucoid Degeneration of Posterior Cruciate Ligament Leads to Roof Impingement with Anterior Cruciate Ligament: Case Report. Ellman MB, et al. However, young patients . I remember that Dr. Jain came out from his clinic to see my mother because my mother was not able walk a single step. An ACL injury is a tear or sprain of the anterior cruciate (KROO-she-ate) ligament (ACL) one of the strong bands of tissue that help connect your thigh bone (femur) to your shinbone (tibia).ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, jumping and landing such as soccer, basketball, football and downhill skiing. The authors presume that this objective end point suggests adequate debulking, just enough to remove the impingement factor from the lateral femoral condyle, femoral notch and PCL, and consequently the symptoms associated with the impingement. It results in postoperative laxity, but rarely in frank instability. Accumulation of mucopolysaccharides at the meniscal interstitial area disrupts the collagen network and weakens the meniscus. 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. 4 McIntyre J, Moelleken S, Tirman P: Mucoid degeneration of the anterior cruciate ligament mistaken for ligamentous tears . Anterior cruciate ligament (ACL) injuries. It also prevents excessive tibial medial and lateral rotation, as well as varus and valgus stresses [1]. For treatment of this, partial removing of bulky ACL is generally done, which causes weakness of the ACL. However, the terminal ROM achieved after debulking MD-ACL was significantly better (p<0.05) at 2years of follow-up as compared with the group that did not undergo debulking. 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. Before an appointment, be prepared to answer the following questions: Mayo Clinic does not endorse companies or products. Clin Orthop Surg 10(3):307314. . Breast cancer is one of the most common cancers in women, with more than 2 million new diagnoses last year alone. Physiotherapy. Mucoid degeneration of ACl is a rare pathological process involving knee joint. Mayo Clinic, Rochester, Minn. Nov. 24, 2018. Accessed Nov. 13, 2018. Intraosseous increased signal is present within the tibial spine deep to the posterior extent of the ACL insertion (arrowhead). [5] and Chudasama etal. Google Scholar, Lintz F, Pujol N, Boisrenoult P, Bargoin K, Beaufils P, Dejour D (2011) Anterior cruciate ligament mucoid degeneration: a review of the literature and management guidelines. Surgery is typically not needed. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). In these patients, when UKA is coupled with debulking of the MD-ACL with a predetermined end point, a significant improvement in the overall ROM, rest pain, functional outcome scores and subjective satisfaction of the patient can be achieved. Ventura etal. It is commonly associated with characteristic clinical findings such as progressive knee pain and discomfort on prolonged sitting or standing in a fixed posture, without history of a significant trauma or instability preceding the symptoms. T2-weighted sagittal view demonstrates localized fluid signal within the ACL (arrows). maude adverse event report: genzyme biosurgery (ridgefield) synvisc one intra-articular hyaluronic acid Follow the R.I.C.E. Plain radiographs were taken in anteroposterior and lateral views at 2years follow-up for radiological analysis in the form of implant failure in all patients or anterior tibial translation in group B by a blinded radiologist. AskMayoExpert. The demographic data of the study population is presented in Table 1. American Academy of Orthopaedic Surgeons. Imagination. Pre-operative and follow-up lateral radiographs of the patients who underwent debulking were analysed by a blinded radiologist and no posterior translation of the femur was noted, thereby confirming no instability caused by the debulking (Fig.
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