Helito Camilo Partezani, Silva Andre Giardino Moreira da, Giglio Pedro Nogueira, Pádua Vitor Barion Castro de, Pécora José Ricardo, Gobbi Riccardo Gomes
Departamento de Ortopedia e Traumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Grupo de Joelho, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2023 Oct 30;58(5):e760-e765. doi: 10.1055/s-0043-1776138. eCollection 2023 Oct.
To evaluate the incidence of symptomatic cyclops lesions requiring surgical treatment after anterior cruciate ligament (ACL) reconstruction and to establish possible intraoperative risk factors related to it. Three hundred and eighty-nine patients aged between 18 and 50 years who underwent primary ACL reconstruction were retrospectively evaluated. Patients were divided into groups according to the presence or absence of symptomatic cyclops lesions, and their characteristics were compared. Patients with associated lesions that required additional surgical procedures (except anterolateral extra-articular procedures) were not included. The rate of symptomatic cyclops lesions was recorded and the following parameters were evaluated: age, gender, time from injury to surgery, graft type and diameter, femoral tunnel perforation technique, fixation type, presence of knee hyperextension, preservation of the ACL remnant, associated anterolateral extra-articular procedure, associated meniscal injury and participation in sports. 389 patients were evaluated and 26 (6.7%) patients developed cyclops. The patients with and without cyclops lesions did not differ in age, time from injury to surgery, graft type or diameter, surgical technique, femoral fixation method, presence of knee hyperextension, remnant preservation and associated meniscal injury. The group with cyclops lesion had a higher proportion of females (10 (38.4%) vs 68 (18.7%); OR = 2.7; = 0.015), higher proportion of extra-articular reconstruction (18 (11.8%) vs 8 (3.4%); OR = 3.8; = 0.001) and higher proportion of sports practice (23 (8.6%) vs 3 (2.5%); OR = 3.6; = 0.026). In our series, 6.7% of the patients required arthroscopic removal of cyclops lesions. Female gender, associated extra-articular reconstruction and sports practice were factors related to this lesion. Remnant preservation had no relationship with cyclops lesion formation.
评估前交叉韧带（ACL）重建术后需要手术治疗的有症状“独眼巨人”病变的发生率，并确定与之相关的可能术中危险因素。 对389例年龄在18至50岁之间接受初次ACL重建的患者进行回顾性评估。根据是否存在有症状的“独眼巨人”病变将患者分组，并比较其特征。排除需要额外手术操作（前外侧关节外手术除外）的相关病变患者。记录有症状“独眼巨人”病变的发生率，并评估以下参数：年龄、性别、受伤至手术的时间、移植物类型和直径、股骨隧道钻孔技术、固定类型、膝关节过伸情况、ACL残端保留情况、相关的前外侧关节外手术、相关半月板损伤及运动参与情况。 对389例患者进行评估，26例（6.7%）患者出现“独眼巨人”病变。有和没有“独眼巨人”病变的患者在年龄、受伤至手术的时间、移植物类型或直径、手术技术、股骨固定方法、膝关节过伸情况、残端保留及相关半月板损伤方面无差异。出现“独眼巨人”病变的组女性比例更高（10例（38.4%）对68例（18.7%）；OR = 2.7；P = 0.015），关节外重建比例更高（18例（11.8%）对8例（3.4%）；OR = 3.8；P = 0.001），运动参与比例更高（23例（8.6%）对3例（2.5%）；OR = 3.6；P = 0.026）。 在我们的系列研究中，6.7%的患者需要关节镜下切除“独眼巨人”病变。女性性别、相关的关节外重建和运动参与是与该病变相关的因素。残端保留与“独眼巨人”病变形成无关。
