Wang Jian, Ao Yingfang
Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
Arthroscopy. 2009 Jun;25(6):626-31. doi: 10.1016/j.arthro.2008.12.006. Epub 2009 Feb 23.
The purpose of this study was to retrospectively evaluate patients after anterior cruciate ligament (ACL) reconstruction in whom a cyclops lesion developed to seek the etiologic factors.
From 1999 to 2005, we observed 48 cases of cyclops lesions in 311 cases arthroscopically while removing the internal fixation devices after ACL reconstruction. Before removing the hardware, the function of the knee was evaluated through symptoms, signs, radiography, and KT-2000 measurement (MEDmetric, San Diego, CA) in 311 cases. Histologic examination was performed on some of the resected lesions.
Of the 311 patients, 45 were found to have nodular formations in the anterior part of the knee; this caused extension loss in 6 patients. Extension loss occurred at 2 to 3 months after ACL reconstruction. Histologic results were available in 18 patients (6 complained of a loss of extension and 12 were asymptomatic). Microscopic examination of the resected fibrous nodules showed disorganized fibrous connective tissue. We found that 8 nodules (4 with extension loss and 4 without extension loss) contained chondroid tissues, but we did not find osseous tissue in the nodules. The histologic appearance was similar to hypertrophic, degenerative granulation tissue.
Among 311 second-look arthroscopies after ACL reconstruction, 45 cyclops lesions were found with a typical histology indicating an inflammatory proliferation with disorganized fibrous tissue, with some having chondroid tissue. Clinically, 10 patients had not returned to sporting activities: 6 of 6 who had extension loss and 4 of 39 who had full range of motion. All 6 patients with extension loss had full motion after resection of the cyclops lesion.
Level IV, therapeutic case series.
本研究旨在回顾性评估前交叉韧带（ACL）重建术后出现独眼巨人病变的患者，以探寻病因。
1999年至2005年，我们在311例ACL重建术后取出内固定装置的患者中，通过关节镜观察到48例独眼巨人病变。在取出内固定装置前，对311例患者的膝关节功能进行了症状、体征、影像学及KT-2000测量（MEDmetric，加利福尼亚州圣地亚哥）评估。对部分切除的病变进行了组织学检查。
311例患者中，45例在膝关节前部发现有结节形成；其中6例出现伸直受限。伸直受限发生在ACL重建术后2至3个月。18例患者有组织学检查结果（6例主诉伸直受限，12例无症状）。对切除的纤维结节进行显微镜检查，显示纤维结缔组织紊乱。我们发现8个结节（4例有伸直受限和4例无伸直受限）含有软骨样组织，但在结节中未发现骨组织。组织学表现类似于肥厚性、退行性肉芽组织。
在311例ACL重建术后的二次关节镜检查中，发现45例独眼巨人病变，其典型组织学表现为纤维组织紊乱的炎性增生，部分含有软骨样组织。临床上，10例患者未恢复体育活动：6例伸直受限患者中的6例，以及39例活动范围正常患者中的4例。所有6例伸直受限患者在切除独眼巨人病变后活动均恢复正常。
IV级，治疗性病例系列。
