Bouguennec Nicolas, Orce Aida, Laboudie Pierre, Pelletier Simon, Dexhelet Jeremy, Graveleau Nicolas
Sports Clinic of Bordeaux-Merignac, Merignac, France.
Orthop J Sports Med. 2023 Feb 28;11(2):23259671221147869. doi: 10.1177/23259671221147869. eCollection 2023 Feb.
The risk of cyclops syndrome increases significantly after anterior cruciate ligament (ACL) reconstruction (ACLR) if complete extension is not recovered before the sixth postoperative week. The lockdown in France due to the COVID-19 pandemic led to an absence of supervised rehabilitation, requiring unexpected self-rehabilitation in patients who underwent ACLR just before lockdown.
To determine the rate of cyclops syndrome after ACLR in patients who underwent self-rehabilitation during lockdown.
Cohort study; Level of evidence, 3.
A total of 75 patients receiving a hamstring graft for ACLR during the COVID-19 pandemic between February 10, 2022, and March 16, 2020, carried out self-rehabilitation during part of their first 6 postoperative weeks using exercise videos on a dedicated website. Clinical examination was performed at a minimum 1-year follow-up with International Knee Documentation Committee (IKDC), Lysholm, Tegner, and ACL-Return to Sport after Injury (ACL-RSI) scores. This group was compared with a matched-pair control group of 72 patients who underwent surgery in 2019 and completed postoperative supervised rehabilitation with a physical therapist. Rates and reasons for second surgery (arthrolysis, meniscal procedure) were also recorded.
In the COVID group (n = 72; 3 patients were lost to follow-up), the mean follow-up was 14.5 ± 2.1 months (range, 13-21) and rate of reoperation for clinical cyclops syndrome was 11.1% (n = 8). The rate of cyclops syndrome was significantly lower (1.4%) in the control group ( = .01). In the COVID group, 8 patients underwent anterior arthrolysis at a mean of 8.6 months after the primary surgery, and 4 patients underwent another surgical intervention (meniscal procedure [n = 3], device removal [n = 1]). In the COVID group, mean Lysholm was 86.6 ± 14.1 (range, 38-100), Tegner was 5.6 ± 2.3 (range, 1-10), subjective IKDC was 80.3 ± 14.7 (range, 32-100) and ACL-RSI score was 77.3 ± 19.7 (range, 33-100).
The rate of cyclops syndrome after ACLR was significantly greater in the COVID group versus the matched controls. The dedicated website was not effective at supporting self-guided rehabilitation and could benefit from interactive improvements so it is at least as effective as supervised rehabilitation.
如果在前交叉韧带（ACL）重建术（ACLR）后第六周前未恢复完全伸直，则独眼巨人综合征的风险会显著增加。由于新冠疫情法国实施的封锁导致缺乏监督康复，这使得在封锁前刚接受ACLR的患者需要意外地进行自我康复。
确定在封锁期间进行自我康复的ACLR患者中独眼巨人综合征的发生率。
队列研究；证据等级，3级。
共有75例在2020年2月10日至2022年3月16日新冠疫情期间接受绳肌移植进行ACLR的患者，在术后前6周的部分时间里使用专门网站上的锻炼视频进行自我康复。在至少1年的随访时进行临床检查，记录国际膝关节文献委员会（IKDC）、Lysholm、Tegner和ACL损伤后恢复运动（ACL-RSI）评分。将该组与72例2019年接受手术并在物理治疗师监督下完成术后康复的配对对照组进行比较。还记录了二次手术（关节松解术、半月板手术）的发生率和原因。
在新冠组（n = 72；3例失访）中，平均随访时间为14.5±2.1个月（范围13 - 21个月），临床独眼巨人综合征的再次手术率为11.1%（n = 8）。对照组中独眼巨人综合征的发生率显著更低（1.4%）（P = 0.01）。在新冠组中，8例患者在初次手术后平均8.6个月接受了前路关节松解术，4例患者接受了另一次手术干预（半月板手术[n = 3]，取出器械[n = 1]）。在新冠组中，Lysholm平均分为86.6±14.1（范围38 - 100），Tegner评分为5.6±2.3（范围1 - 10），主观IKDC评分为80.3±14.7（范围32 - 100），ACL-RSI评分为77.3±19.7（范围33 - 100）。
与配对对照组相比，新冠组ACLR后独眼巨人综合征的发生率显著更高。专门网站在支持自我引导康复方面效果不佳，可从交互式改进中受益，以便至少与监督康复一样有效。
