Arens Tabea, van Melick Nicky, van der Steen Maria C, Janssen Rob P A, Bogie Rob
Sports & Orthopedics Research Center, Anna Hospital, Geldrop, The Netherlands.
Department of Orthopedic Surgery & Trauma, Máxima MC, Eindhoven, The Netherlands.
Knee Surg Sports Traumatol Arthrosc. 2024 Jun;32(6):1414-1422. doi: 10.1002/ksa.12142. Epub 2024 Apr 2.
Risk factors for the development of symptomatic cyclops lesion after anterior cruciate ligament reconstruction (ACLR) surgery are not entirely identified yet. This study aimed to investigate whether the choice of hamstring graft (semitendinosus-gracilis; STG vs. semitendinosus; ST) affects the risk of developing a symptomatic cyclops lesion after ACLR.
This retrospective cohort study included 1416 patients receiving either an ST graft (n = 1209) or an STG graft (n = 207) ACLR with a follow-up of at least 2 years. A persisting extension limitation was clinically determined, and cyclops lesions were confirmed by magnetic resonance imaging (MRI) and second-look arthroscopy. Graft-specific incidence of cyclops lesions was examined with χ test and combined with the factors number of graft bundles, graft diameter and sex evaluated with a binominal logistic regression model.
In total, 46 patients developed symptomatic cyclops lesions (3.2%), with 36 having ACLR with an ST graft (3.0%) and 10 with an STG graft (4.8%) (n.s). The mean time from ACLR to the second-look arthroscopy for cyclops removal was 1.1 ± 0.6 years. Female patients were 2.5 times more likely to develop a cyclops lesion than male patients. Patients with an STG graft and larger graft diameters did not have a higher risk of developing cyclops lesions. Patients who received an STG graft with both tendons folded four times (double-quadruple) had significantly higher risk of developing a cyclops compared with all other numbers of graft bundles combined (8.3%, respectively 3.0%; p = 0.014).
This study could not prove an increased risk of developing a symptomatic cyclops lesion for patients with an STG graft compared with an ST graft used for ACLR. However, patients with a double-quadruple ACLR had a higher percentage of cyclops lesions compared with all other numbers of graft bundles. Female sex was associated with an increased risk of developing cyclops lesions.
Level III.
前交叉韧带重建（ACLR）手术后出现症状性“独眼巨人”病变的危险因素尚未完全明确。本研究旨在调查腘绳肌移植物的选择（半腱肌-股薄肌；STG与半腱肌；ST）是否会影响ACLR后出现症状性“独眼巨人”病变的风险。
这项回顾性队列研究纳入了1416例行ACLR手术的患者，其中1209例使用ST移植物，207例使用STG移植物，随访时间至少为2年。通过临床检查确定是否存在持续的伸直受限，并通过磁共振成像（MRI）和二次关节镜检查确诊“独眼巨人”病变。采用χ检验检查“独眼巨人”病变的移植物特异性发生率，并结合移植物束数量、移植物直径和性别等因素，使用二项逻辑回归模型进行评估。
共有46例患者出现症状性“独眼巨人”病变（3.2%），其中36例为使用ST移植物的ACLR患者（3.0%），10例为使用STG移植物的患者（4.8%）（无统计学差异）。从ACLR到进行二次关节镜检查切除“独眼巨人”病变的平均时间为1.1±0.6年。女性患者发生“独眼巨人”病变的可能性是男性患者的2.5倍。使用STG移植物且移植物直径较大的患者发生“独眼巨人”病变的风险并不更高。与所有其他移植物束数量组合相比，接受双股四折STG移植物的患者发生“独眼巨人”病变的风险显著更高（分别为8.3%和3.0%；p = 0.014）。
本研究未能证明与ACLR中使用ST移植物的患者相比，使用STG移植物的患者发生症状性“独眼巨人”病变的风险增加。然而，与所有其他移植物束数量相比，双股四折ACLR患者的“独眼巨人”病变发生率更高。女性与发生“独眼巨人”病变的风险增加相关。
III级。
