Mucoid degeneration of the ACL is a very rare cause of knee pain. It results in postoperative laxity, but rarely in frank instability. Google Scholar, Cha JR, Lee CC, Cho SD, Youm YS, Jung KH (2013) Symptomatic mucoid degeneration of the anterior cruciate ligament. It happens to everyone in the country from little girls to middle- Family. This replacement tissue is called a graft. Anterior Cruciate Ligament (ACL) MRI: Practice Essentials, Anatomy Laskowski ER (expert opinion). This site complies with the HONcode standard for trustworthy health information: verify here. How long does it take an ACL to heal without surgery? The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. During the physical exam, your doctor will check your knee for swelling and tenderness comparing your injured knee to your uninjured knee. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. 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. Diffuse Intrasubstance Signal Abnormalities Ofthe Posterior Cruciate It included all patients who were diagnosed with mucoid degeneration of ACL and underwent mobile-bearing Oxford partial knee arthroplasty between January 2017 and February 2020, by consecutive sampling method. The median age of the affected population is estimated to be 51years [5]. -Provided skilled hands on in post-op rehabilitation to various population including Head and neck cancers, Lymph edema management, Bone cancers. He did total knee replacement on both side and now my mother is walking without aid. Let others know if this answer was helpful Stability of the joint is not compromised on controlled debulking. [21]. These patients may complain of pain and stiffness, and large ganglia may cause limitation of extension. -Evaluated and planned treatment protocol in accordance with physician. Anterior cruciate ligament ganglion cyst with intraosseous extension. Google Scholar, Sweed T, Mussa M, El-Bakoury A, Geutjens G, Metcalfe A (2021) Management of mucoid degeneration of the anterior cruciate ligament: a systematic review. 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 provides objective end points for open debulking of mucoid ACL in these patients and, being a multicentric study, it entails external validity of this procedure in a diverse population. ACL injury - Diagnosis and treatment - Mayo Clinic [22]. #radiologycpd #medicalimaging #imaging #radcme #rheumatology #arthritis #rheumatologist #orthopaedic #painphysician #physiotherapy #sportsmed #orthopaedic #mskmri. 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. An anteriorly protruding ganglion (arrow) arising from an ACL ganglion cyst (arrowheads) is well seen on a proton density-weighted sagittal image. Advertising revenue supports our not-for-profit mission. Imagination. One MRI was reported as a possible ganglion cyst or mucoid degeneration of the ACL, whereas all others were reported as either partial or complete tears of the ACL. It's important to ensure that strength, stability and movement patterns are optimized before you return to an activity with a risk of ACL injury. 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. Main symptoms are pain during terminal knee flexion (as in squatting) feeling of heaviness/tiredness in the knee. [21] and Ventura etal. Your 3-year nephew sta News comes out day after day about sexual harassment. 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. Su Chan Lee, Kyung Won . Platelet-rich plasma (PRP) is known to influence musculoskeletal healing through multiple growth factors. (Table 2). Purpo. Mucoid Degeneration of Posterior Cruciate Ligament Leads to Roof Impingement with Anterior Cruciate Ligament: Case Report. Freedom from war and natural disaster. Manage cookies/Do not sell my data we use in the preference centre. The ACL appears on MRI to be enlarged with cystic changes throughout, however it is intact. We believe that meniscal mucoid degeneration with tear is not uncommon. The results found improved functional scores and pain scores compared with preoperative levels. Grade 1: The ligament is intact, and the joint is stable, but there is minimal stretching and some microscopic tearing of the ACL. Have your symptoms been continuous or occasional? The ACL graft (arrow) is abnormally lax and demonstrates abnormally increased signal intensity, likely secondary to degeneration from chronic mechanical stress. In: Current Medical Diagnosis & Treatment 2019. The anterior cruciate ligament (ACL) is an important ligament in the knee. Modalities such as icing, joint mobilization, and massage can provide short-term pain relief and reduce swelling. The Infona portal uses cookies, i.e. Treatment of Atherosclerotic Disease of the Femoral Artery: Randomized Controlled Trials and Meta-Analyses. 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. strings of text saved by a browser on the user's device. It can be misdiagnosed a partial ACL tear. PubMedGoogle Scholar. A surgical procedure that involves replacing a damaged, worn or diseased knee with an artificial joint to restore knees movement. The ligament can also tear due to work injuries or automobile accidents. 1 Brown MF, Dandy DJ: Intra-articular ganglia in the knee. Mucoid degeneration of acl (anterior cruciate ligament) is not a common problem and mostly it is found in female patients. was the primary surgeon and was responsible for the conceptualization, methodology, supervision, writing review and editing. Mucoid degeneration of the anterior cruciate ligament (ACL) is a clinical condition observed primarily in middle-aged patients presenting with knee pain and limited range of motion in the absence of symptoms of instability or a significant history of trauma [].ACL mucoid degeneration causes knee pain less frequently than meniscal tears or chondral defects [17, 18] and has been rarely reported . Role of debulking mucoid ACL in unicompartmental knee arthroplasty: a prospective multicentric study. The MR-findings of mucoid degeneration of the ACL include: an ill-defined ACL; an increased ligamentous girth Subsequently, the final sample included 442 patients who were followed-up for at least 2years after surgery (Fig. The patients clinical history and symptoms do not support an ACL injury. He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. Provided by the Springer Nature SharedIt content-sharing initiative. American Journal of Sports Medicine. 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. Which Teeth Are Normally Considered Anodontia. Cookies policy. Background. . What is thickening of the ACL? - AnswersAll (PDF) Anterior Cruciate Ligament Ganglion Cyst and Mucoid Degeneration A total of 442 patients (na=216; nb=226) fulfilled the inclusion criteria and were followed up until a minimum of 2years post-surgery (mean: 252.46months; range: 2427.5months). Mucoid degeneration of the anterior cruciate ligament, International Knee Documentation Committee, Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK (1999) Mucoid cystic degeneration of the cruciate ligament. The treatment alternatives, indications for the planned procedure and risks were discussed with her in detail and an informed consent was obtained. After surgery patient is allowed to walk from the next day. Outcome of Arthroscopic Treatment of Mucoid Degeneration of the 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. These cysts have a variable MR appearance and are not always confined to the substance of the ligament. To summarize, 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. 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%). 2 Kaplan PA, Helms CA, Dussault R, Anderson MW, Major NM: Musculoskeletal MRI. Patients will . The authors did not perform stress tests. These tests may include: Prompt first-aid care can reduce pain and swelling immediately after an injury to your knee. https://doi.org/10.20546/ijcrar.2016.411.003, Chudasama CH, Chudasama VC, Prabhakar MM (2021) Arthroscopic management of mucoid degeneration of anterior cruciate ligament. However, in the case of mucoid degeneration . California Privacy Statement, I have multiple issues - spondylolisthesis in L4/L5 and L5/S1, osteopenia and osteoarthritis. Did you hear a loud pop or feel a "popping" sensation? PDF Plaintiff, MAGISTRATE JUDGE vs. JONATHAN D. GREENBERG Does your knee ever "lock" or feel blocked when you're trying to move it? 373) A September 2018 MRI of the left knee showed anterior cruciate ligament and mucoid degeneration with intra cruciate ganglion and pericruciate synovitis . DOC Operative Note Clinical significance of T2*-weighted gradient-echo MRI to monitor . https://doi.org/10.4103/0019-5413.128765, Article Mucoid degeneration of the anterior cruciate ligament (ACL) has been shown to cause restricted terminal range of motion and rest pain. He or she may also move your knee into a variety of positions to assess range of motion and overall function of the joint. (7a) Intra-articular extension of a cruciate ligament ganglion. Go to the Bones, Joints & Muscles Support Group. https://link.springer.com/10.1007/s00590-021-03198-4. ACL Graft Tear - Radsource But many studies have reported the weakening and laxity of ACL postoperatively and on follow-up. Mucoid degeneration of ACL is a disease affecting ACL in which mucoid like substance (glycosaminoglycans) gets interspersed within the substance of ACL and as a result ACL gets thickened. Demographic, radiological, and histological findings, type of surgery, and clinical pre- and postoperative data were analyzed. Secondly, all the patients underwent the surgery and postoperative rehabilitation based on a standardized protocol which may limit the reproducibility of results if not adhered to. If the address matches an existing account you will receive an email with instructions to reset your password. The abnormal sliding within the knee also can hurt cartilage. Diagnosis. Complete your request online or contact us by phone. Some patient may also complain of pain with full knee extension. Anterior and posterior cruciate ligament ganglion cysts are reported in the literature as being rare with an incidence of approximately 0.5% to 1%.1,2 However, in our experience, this entity is encountered more commonly, most often within the anterior cruciate ligament. There have been only some reported cases of mucoid degeneration of the ACL in the English literature. The cruciate ligaments control the back and forth motion of your knee. Subsequently, from January 2019, the surgeons started debulking the MD-ACL. You're an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting, More than one ligament or the fibrous cartilage in your knee also is injured, The injury is causing your knee to buckle during everyday activities. https://doi.org/10.4055/cios.2018.10.3.307. on nine studies [8]. Treatment of ACL mucoid degeneration by arthroscopic resection is effective for posterior pain and flexion limitation. Paterno MV, et al. At the time of the injury, a "pop" or "snap . When considering a UKA in such a patient, a plethora of dilemmas may arise in the mind of an orthopaedic surgeon vis a vis preserving the MD-ACL at the cost of functional limitation, or debulking it and predisposing the UKA to failure owing to instability. In: DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. 3, 2018 www.ecios.org Mucoid degeneration (MD . : tissue degeneration marked by conversion of cell substance into a glutinous substance like mucus. Not really known: Mucoid degeneration of the ACL is seen most commonly in adults (35-55 years of age). Without adequate and timely treatment, . Introduction: Mucoid degeneration of the anterior cruciate ligament (ACL) is commonly treated with arthroscopic debridement of the ACL. 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. Here are the search results of the thread mucoid degeneration of acl treatment from Bing. 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. Google Scholar, Irrgang JJ, Anderson AF, Boland AL (2001) Development and validation of the international knee documentation committee subjective knee form. J Comput Assist Tomogr 1996 Jan-Feb; 20(1): 80-4. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Recent studies have reported that the prevalence of ACL mucoid degeneration is approximately 2-14% [20, 23, 24, 25]. 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 . By using this website, you agree to our 2001. . Before an appointment, be prepared to answer the following questions: Mayo Clinic does not endorse companies or products. Both groups showed overall improvement after surgery, however, patients who underwent debulking performed better at 2years follow-up in terms of Knee Society functional score, International Knee Documentation Committee scores, range of motion, rest pain and overall patient satisfaction (p<0.05) as compared with their counterparts. ACL mucoid degeneration is present on ~10% (range 9-12%) of 3 T MRI examinations and 2% of 1.5 T MRI examinations 6. It is postulated that mucoid degeneration may be a predisposing factor to the formation of ACL ganglion cysts . 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 . The second most common complaint in patients with MD-ACL, namely rest pain, also showed statistically significant reduction at 2years follow-up in patients who underwent debulking as compared with their counterparts, as measured by VAS score. Am J Sports Med 29(5):600613. Justamom21. Score: 4.7/5 (45 votes) . Intraosseous ganglion 6. The first resembles ganglia in other periarticular locations, presenting as a discrete fluid signal cystic structure within the substance or on the surface of the ACL(5a).3 The second form has been likened to a celery stalk in appearance.4 The ACL demonstrates diffuse thickening containing ill-defined intraligamentous T2-hyperintensity, which splays the intact ACL fibers (6a). https://doi.org/10.1302/0301-620X.93B4.25562, Mittal A, Meshram P, Kim WH, Kim TK (2020) Unicompartmental knee arthroplasty, an enigma, and the ten enigmas of medial UKA. https://doi.org/10.1007/s00167-012-1991-9, Pandey V, Suman C, Sharma S, Rao SP, Kiran Acharya K, Sambaji C (2014) Mucoid degeneration of the anterior cruciate ligament: management and outcome. . PubMed It can cause pain and to a meniscal tear. : any of various mucoproteins that occur especially in secretions of mucous membranes. The time it takes to recover is approximately 3 months. [20], Chudasama etal. Others may make an appointment with their family doctors. How is mucoid degeneration treated? - sdnimik.bluejeanblues.net What does mucoid degeneration of posterior horn of medial - HealthTap TimesMojo is a social question-and-answer website where you can get all the answers to your questions. ), or their login data. The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. J Comput Assist Tomogr 1996 Jan-Feb; 20(1): 80-4. My knee pains while I sit on the floor or its difficult for me to stand or walk for a long time or I find its difficult to descend the stairs or my knee gets tired easily these days are the usual complaints. Treatment is only required if there are otherwise unexplained symptoms. . These are found inside your knee joint. Mucoid degeneration of the anterior cruciate ligament They assessed the stability of the joint with the Lachman test intra-operatively, confirming it to be either grade zero or one, with firm end point, before commencing with the UKA [16]. Considering a dearth of studies that evaluates the effect of debulking an ACL with mucoid degeneration, more prospective studies with larger sample size and longer follow-up period are encouraged to corroborate the findings of this study. J Bone Jt Surg Ser B 81(2):304305. b Open debulking of mucoid ACL under direct vision using 15-number blade. Health. The main MRI finding of ACL mucoid degeneration is a celery stalk appearance [26, 27]. Knee Surg Sports Traumatol Arthrosc 19(8):13261333. Arthroscopic Treatment of Mucoid Degeneration of the Anterior Cruciate Ligament Clinics in Orthopedic Surgery Vol. Exclusion criteria was as follows: (1) patients with a previous history of having undergone reconstruction, repair or debulking of the ACL in the ipsilateral knee; (2) patients with a history of any surgery in and around the ipsilateral or contralateral knee, or ipsilateral hip or ankle joints; (3) patients with inflammatory arthritis; (4) patients with musculoskeletal and learning disorders and (5) patients diagnosed with mucoid degeneration of the PCL radiologically. These ganglia consist of myxoid material. ACL MUCOID DEGENERATION RADIOLOGY MRI - Radedasia Mucoid degeneration of the anterior cruciate ligament: can platelet The ACL can be injured or torn in a number of different ways. Arthroscopic surgeries are key hole surgeries for joint disorders. 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. A June 2018 MRI of the cervical spine found multilevel degenerative changes of the cervical spine, . In terms of treatment, doctors mostly recommend an arthroscopy, a minimally invasive surgical procedure which examines and sometimes . With the advent of the mobile-bearing UKA system, the predilection towards this surgery is on an upward trend. At arthroscopy, the ACL appeared homogenous, bulbous, and hypertrophied in all patients. The demographic distribution of study population with respect to the mean age, gender distribution and the side affected was similar to the recent studies done on the MD-ACL as a standalone entity [2, 3, 5, 8]. New York, N.Y.: McGraw-Hill Education; 2019. https://accessmedicine.mhmedical.com. Without a properly functioning ACL, the other structures of the knee experience greater strain, which causes further injuries to tissues in the knee. 2023 BioMed Central Ltd unless otherwise stated. Treatment options include non-operative management, arthroscopic debridement with a biceps tenotomy or tenodesis, complete or partial repair, patch augmentation, superior capsular reconstruction, muscle/tendon transfer and reverse total shoulder arthroplasty. A total of 488 patients diagnosed with MD-ACL (clinically and radiologically) underwent surgery during this period, of which 46 patients (9.43%) were lost to the minimum 2-year follow-up criteria or to matching of groups. This is a characteristic appearance of ACL mucoid degeneration where the ACL is expanded and hyperintense but is still continuous with normal alignment. Reeducation. After a database search of 4,221 knee MRI examinations, Bergin et al. 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. Accessed Nov. 13, 2018. (i.e., thinning or thickening) or signs of ligament degeneration and attrition such as mucoid degeneration or sclerosis were absent in all specimens. Anterior cruciate ligament injury. Depending on the severity of your injury, you may be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon). Acta Orthop Scand 63(5):497501. It can trap and damage the menisci in the knee and can also lead to early osteoarthritis. Introduction to Arthroscopic Debridement We reviewed previous reports and summarized clinical features and symptoms, including those found in our case. Functional assessment was done by the same clinician using patient-related outcome measures (PROMs) using the self-questionnaire-based International Knee Documentation Committee (IKDC) score, Knee Society score (KSS), VAS score (for rest pain) and subjective satisfaction level. In vivo elongation of the anterior cruciate ligament and posterior cruciate ligament during knee flexion. Am J . the degree of laxity, and the patient's age and willingness to pursue vigorous postoperative physical therapy are other major determinants. Background: There has been a substantial increase in the amount of systematic reviews and meta-analyses published on the anterior cruciate ligament (ACL). The samples collected from the five hospitals were 122 (group A: 58; group B: 64), 68 (group A: 35; group B: 33), 94 (group A: 46; group B: 48), 83 (group A: 41; group B: 42) and 75 (group A: 36; group B: 39), respectively. This content does not have an English version. Truncation means that the . model of self-care at home: Medical treatment for an ACL injury begins with several weeks of rehabilitative therapy. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Anterior Cruciate Ligament (ACL) Injury or Tear - Hopkins Medicine (Tr. Two characteristic MR appearances have been described for ganglion cysts of the ACL. Recent research indicates that up to one-third of athletes sustain another tear in the same or opposite knee within two years.
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