Money Adam J, Pullen W Michael, Safran Marc R, Abrams Geoffrey D, Sherman Seth L
Rothman Orthopaedic Institute Florida, Winter Garden, Florida, USA.
Medical University of South Carolina, Charleston, South Carolina, USA.
Video J Sports Med. 2024 Dec 18;4(6):26350254241293462. doi: 10.1177/26350254241293462. eCollection 2024 Nov-Dec.
Cyclops lesion after anterior cruciate ligament (ACL) reconstruction can appear on magnetic resonance imaging (MRI) in up to 30% of patients and is symptomatic in up to 9%. Arthroscopic cyclops removal can help restore motion and limit recurrence.
Patient is an 18-year-old male high-level collegiate athlete with a mechanical block to full extension. Patient underwent ACL reconstruction with bone-patellar tendon-bone autograft 15 months prior by an outside physician. The patient had a stable Lachman and pivot-shift examination, but there was a palpable clunk when attempting to extend his knee the final 10°. Patient was unable to perform sport due to symptoms. Postoperative MRI demonstrated a large cyclops lesion.
Bilateral ligamentous examination under anesthesia was performed prior to draping. Standard arthroscopy portals were used. Diagnostic arthroscopy was performed by assessing all critical structures in the knee (ie, meniscus, cartilage, and ligaments). The cyclops lesion was visualized in the intercondylar notch with clear evidence of superior notch impingement with knee extension. Using a standard shaver and radiofrequency ablation, the cyclops lesion was resected with care not to injure the ACL graft or disrupt its integrity. A small superior soft tissue resection was then performed with resection of scar tissue that had formed within the notch. A repeat examination with an arthroscope in the knee revealed no further impingement.
Patient was able to return fully to sport at 8 weeks postoperatively with no limitations, with no return of clicking or loss of motion.
DISCUSSION/CONCLUSION: Symptomatic cyclops lesion after ACL reconstruction can be effectively treated with arthroscopic debridement. Postoperatively, patients can return to full sport at 6 to 8 weeks.
The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
前交叉韧带（ACL）重建术后的独眼巨人病变在磁共振成像（MRI）上的出现率高达30%的患者，有症状的比例高达9%。关节镜下切除独眼巨人病变有助于恢复活动度并限制复发。
患者为一名18岁的男性高水平大学运动员，存在完全伸直的机械性阻挡。患者15个月前由外院医生采用自体骨-髌腱-骨移植进行了ACL重建。患者Lachman试验和轴移试验结果稳定，但在试图将膝关节伸直最后10°时可触及卡顿。患者因症状无法进行运动。术后MRI显示有一个大的独眼巨人病变。
铺巾前在麻醉下进行双侧韧带检查。使用标准的关节镜入路。通过评估膝关节的所有关键结构（即半月板、软骨和韧带）进行诊断性关节镜检查。在髁间切迹中可见独眼巨人病变，有明确证据表明在膝关节伸直时上切迹受到撞击。使用标准刨削器和射频消融，小心切除独眼巨人病变，避免损伤ACL移植物或破坏其完整性。然后进行小范围的上软组织切除，切除切迹内形成的瘢痕组织。再次用关节镜检查膝关节，显示无进一步撞击。
患者术后8周能够完全恢复运动，无任何限制，无弹响复发或活动度丧失。
讨论/结论：ACL重建术后有症状 的独眼巨人病变可通过关节镜清创有效治疗。术后，患者可在6至8周恢复全面运动。
作者证明已获得本出版物中出现的任何患者的同意。如果个体可能被识别，作者已随本投稿发表包含患者的豁免声明或其他书面批准形式。
