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J Knee Surg 2021; 34(05): 546-551
DOI: 10.1055/s-0039-1697625
Original Article

A Simple Method to Reduce the Incidence of Cyclops Lesion after Anterior Cruciate Ligament Reconstruction

Keita Nagira 
1   Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
,
Makoto Enokida
1   Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
,
Ikuta Hayashi
1   Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
,
Koji Ishida
1   Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
,
Haruhisa Kanaya
1   Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
,
Hideki Nagashima
1   Department of Orthopedic Surgery, Tottori University, Yonago, Tottori, Japan
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Abstract

The purpose of this study is to determine the influence of debridement in and around the bone tunnels on the prevalence of cyclops lesion (CL), after anterior cruciate ligament reconstruction (ACLR) with hamstring grafts. Our hypothesis was that bone tunnel debridement during ACLR would reduce the prevalence of CL. Methods for debridement in and around the bone tunnels after tunnel drilling were standardized and applied to 38 knees undergoing double-bundle ACLR between 2011 and 2014, Group A (debridement group). Group B (nondebridement group) included 56 knees in which bone tunnel debridement was not performed. Postoperative MRI was performed to evaluate the presence of CL and the following three criteria: (1) the intercondylar site of CL (grade 1–3), depending on its anterior extent along the femoral condyle; (2) posterior bowing of the ACL graft; and (3) the positional relationship between the frontmost fiber of ACL graft and Blumensaat's line. If CL caused loss of extension or pain or discomfort during knee extension, it was defined as symptomatic CL (SCL). CL was detected in 8 cases (21.1%) in Group A and 26 cases (46.4%) in Group B. The prevalence of CL was significantly lower in Group A than in Group B (p = 0.010), and the risk ratio of CL was 0.31 (95% confidence interval: 0.12–0.79). Furthermore, 10 patients in Group B had SCL, compared with none in Group A (p = 0.004). In Group A, the intercondylar site of CL was grade 1 in all cases, while in Group B, the CL grades were 1 (n = 17), 2 (n = 7), 3 (n = 2) (p = 0.008). There were no cases of posterior bowing of the ACL in Group A, but six cases in Group B (p = 0.023). Debridement in and around the bone tunnel is a simple and effective method of preventing CL and SCL after ACLR. The level of evidence for the study is 3.

Keywords

cyclops lesion - anterior cruciate ligament reconstruction - debridement - MRI - symptomatic


Publication History

Received: 02 December 2019

Accepted: 12 August 2019

Article published online:
27 September 2019

© 2019. Thieme. All rights reserved.

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