Incidence and risk factors for cyclops syndrome after anterior cruciate ligament reconstruction: A systematic literature review - 10/08/19

Doi : 10.1016/j.otsr.2019.07.007

Thibaut Noailles ^a, Antoine Chalopin ^b, Mathieu Boissard ^c, Ronny Lopes ^d, Nicolas Bouguennec ^e, Alexandre Hardy ^f,⁎
^a Département de Chirurgie Orthopédique, Polyclinique de Bordeaux Nord, 15, rue Claude-Boucher, 33000 Bordeaux, France
^b Département de Chirurgie Orthopédique Infantile, Hôpital Universitaire Hôtel-Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
^c Département de Chirurgie Orthopédique, Polyclinique de l’Atlantique, avenue Claude-Bernard - BP 40419, 44819 Saint Herblain Cedex, France
^d Département de Chirurgie Orthopédique, Clinique Bretéché, 3, rue de la Béraudiere, 44000 Nantes, France
^e Département de Chirurgie Orthopédique, Clinique du Sport, 4, rue Georges-Negrevergne, 33700 Mérignac, France
^f Département de Chirurgie Orthopédique, Hôpital Ambroise-Paré, 9, avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France

^⁎Corresponding author.

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Abstract

Background

Cyclops syndrome after anterior cruciate ligament (ACL) reconstruction is due to a fibrous nodule that develops in the anterior part of the intercondylar notch and prevents full knee extension. The primary objective of this systematic literature review was to evaluate the incidence of symptomatic cyclops lesion after ACL reconstruction. The secondary objective was to identify risk factors for cyclops syndrome.

Hypothesis

Cyclops syndrome is common after ACL reconstruction and has several risk factors reported in the literature.

Methods

A systematic literature review was performed by searching the PubMed, Medline, CINAHL, Cochrane, and Embase databases with the key terms ‘cyclops’ and ‘ACL reconstruction’. The data thus retrieved were evaluated independently by two investigators. All articles in English or French that reported the incidence and risk factors of cyclops syndrome after ACL reconstruction were included.

Results

The search retrieved the titles and abstracts of 79 articles, of which 20 were selected to be read in full; among these, 10 were included in the study. The incidence of symptomatic cyclops lesion ranged from 1.9% to 10.9%. Identified risk factors were as follows: pre-operatively, knee inflammation and/or motion restriction at the time of ACL reconstruction; intra-operatively, narrow intercondylar notch and excessively anterior position of the tibial tunnel; and post-operatively, persistent hamstring muscle spasm.

Discussion

Development of a cyclops lesion is common after ACL reconstruction, occurs early, and may require further surgery. The knowledge of the risk factors provided by this study may improve the ability to devise effective preventive measures.