A symptomatic cyclops lesion 4 years after anterior cruciate ligament reconstruction.
The cyclops lesion is a fibrous nodule with central granulation tissue located anterolateral to the tibial tunnel after intra-articular reconstruction of the anterior cruciate ligament (ACL) that has been shown to be a cause of failure to regain full extension in the early postoperative period. We present the case of a 23-year-old woman who had undergone arthroscopic ACL reconstruction with a patellar tendon autograft 4 years prior to presentation. Following her reconstruction, she regained full range of motion and returned to collegiate cheerleading. At presentation, she complained of a gradual loss of full extension and joint-line pain with terminal extension. On examination, her graft was stable and she lacked 3 degrees of extension. Magnetic resonance imaging documented a 1-cm mass of low signal intensity immediately anterior to the ACL graft within the intercondylar notch. At arthroscopy, a large amount of thick, immobile scar tissue was found immediately anterior to the ACL, consistent with a cyclops lesion. The lesion was debrided and the patient did well postoperatively. Patients who present with delayed-onset loss of extension after ACL reconstruction should undergo careful evaluation including radiographs and magnetic resonance imaging. If a cyclops lesion is diagnosed, arthroscopic resection should be undertaken.
Nuccion
S L
SL
Department of Orthopaedic Surgery, UCLA School Of Medicine, Los Angeles, California, U.S.A.
Hame
S L
SL
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D018771:Arthralgia / Q000209:etiology; D001182:Arthroscopy / Q000009:adverse effects*; D001265:Athletic Injuries / Q000601:surgery; D002921:Cicatrix / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D016059:Range of Motion, Articular; D013585:Synovitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery