Centre Orthopédique Paul Santy, 24 Av. Paul Santy, Lyon, France.
Arthroscopy. 2010 Nov;26(11):1483-8. doi: 10.1016/j.arthro.2010.02.034. Epub 2010 Sep 27.
The purpose of this study was to investigate the clinical and operative characteristics of cyclops lesion in a consecutive series of patients with anterior cruciate ligament (ACL) double-bundle reconstruction.
Included were 387 patients who underwent an ACL double-bundle reconstruction with quadriceps or hamstring tendons and were followed up at 6 weeks and 3, 6, and 12 months for clinical examination. When a persistent extension deficit was observed 3 months postoperatively, magnetic resonance imaging was performed to eventually diagnose a cyclops syndrome, and arthroscopic removal of the nodule was performed in these cases. The aspect of the nodule was explored before debridement. These patients were reviewed at a mean follow-up of 12 months (minimum, 6 months; maximum, 20 months) after nodule debridement for evaluation.
There were 14 patients who had cyclops syndrome (3.61%); 10 cases (5.37%) occurred in the quadriceps tendon group and 4 cases (1.99%) in the hamstring tendon group. In the postoperative period these patients had a mean loss of extension of 6° (range, 5° to 15°), and 78.6% had pain and/or swelling. At the 6-week follow-up, 78.6% of the 14 patients had a significant quadriceps dysfunction associated with an active extension deficit. During arthroscopic debridement, the cyclops lesion was always located on the roof of the intercondylar notch. At the last follow-up, 12 patients had full range of motion, but an extension loss was still present in 2 patients. On the International Knee Documentation Committee objective evaluation, 78.5% of patients were graded A, 14.3% were graded B, and 7.2% were graded C.
Cyclops syndrome after double-bundle ACL reconstruction was more frequently observed with quadriceps tendon graft than with hamstring graft. Its unique characteristic is that the nodule localization is from the roof of the intercondylar notch. The majority of the patients with cyclops syndrome presented with a significant quadriceps dysfunction and an active extension deficit in the immediate postoperative period.
Level IV, therapeutic case series.
本研究的目的是探讨前交叉韧带（ACL）双束重建中连续患者的神经节病变的临床和手术特点。
纳入 387 例接受 ACL 双束重建的患者，采用股四头肌或腘绳肌腱，术后 6 周及 3、6、12 个月进行临床检查。术后 3 个月出现持续伸展缺损时，行磁共振成像检查，最终诊断为神经节综合征，并对这些病例行结节切除术。在清创前探查结节的外观。这些患者在结节清创后平均 12 个月（最短 6 个月，最长 20 个月）进行回顾性评估。
共有 14 例患者出现神经节综合征（3.61%）；10 例（5.37%）发生于股四头肌肌腱组，4 例（1.99%）发生于腘绳肌腱组。术后患者平均伸膝丧失 6°（范围 5°~15°），78.6%有疼痛和/或肿胀。在 6 周随访时，14 例患者中有 78.6%出现明显的股四头肌功能障碍和主动伸膝缺陷。在关节镜下清创时，神经节病变始终位于髁间窝顶。末次随访时，12 例患者的活动范围完全正常，但仍有 2 例存在伸膝丧失。在国际膝关节文献委员会（International Knee Documentation Committee）的客观评估中，78.5%的患者评为 A 级，14.3%评为 B 级，7.2%评为 C 级。
双束 ACL 重建后神经节综合征更常发生于股四头肌肌腱移植物，而不是腘绳肌腱移植物。其独特的特征是结节定位在髁间窝顶。大多数神经节综合征患者在术后即刻出现明显的股四头肌功能障碍和主动伸膝缺陷。
IV 级，治疗性病例系列。
