Cyclops syndrome has been defined as a loss of knee extension due to impingement of a pedunculated proliferative tissue mass after anterior cruciate ligament reconstruction. We describe four patients who were operated on for progressive loss of knee extension after minor knee injury. During the arthroscopic procedure, the consistent finding was a fibrous pedunculated nodule adhering to the anterolateral aspect of the original anterior cruciate ligament, obstructing extension by impingement in the anterior aspect of the knee. At least part of the anterior cruciate ligament was intact in all cases. These patients were compared with seven patients who developed cyclops syndrome after anterior cruciate ligament reconstruction. Clinical and arthroscopic findings were the same in both groups. An arthroscopic excision of the nodule, performed an average of 12 weeks after knee trauma or after reconstruction, gave very good results. Histologic examination of the excised nodules from both groups showed fibroelastic connective tissue proliferation, thromboangiitis, and areas of necrotic bone and foreign body giant cell granuloma. On the basis of our observations, we conclude that formation of a fibrous pedunculated nodule may occur after an anterior cruciate ligament injury as well as after surgical reconstruction of the anterior cruciate ligament.
Avulsion fracture of the tibial insertion of the posterior cruciate ligament (PCL) is a rare condition. Until recently, bony avulsion fractures of the PCL have been repaired with open reduction and internal fixation. Posterior approach commonly used for open repair is rather extensive, yet it does not allow for detection and management of associated intraarticular injuries of the knee. We report a case of avulsion fracture of the tibial attachment of the PCL managed by arthroscopic reduction and fixation. A large bony fragment that extended into the posterior part of the lateral tibial plateau allowed for reduction and retrograde fixation through anterior portals only.
We report a series of 77 skeletally immature patients (41 children aged < or = 13 years and 36 adolescents aged 14-16 years) who underwent knee arthroscopy. The purpose of the study was to assess the accuracy of clinical diagnosis and the value of arthroscopy. The correlation between clinical and arthroscopic diagnoses was analyzed in 54 patients. Arthroscopy confirmed the clinical diagnosis in 46.29% (25) of the patients. The accuracy of clinical diagnosis in patients aged 13 years and younger was 31.25%, whereas the accuracy in patients aged from 14 years to 16 years was 68.18%. Paediatric knee arthroscopy is a safe procedure that significantly improves the accuracy of clinical diagnosis, allows the definitive treatment of a variety of conditions and often prevents an unnecessary arthrotomy.
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