Analysis of intercondylar notch size and shape in patients with cyclops syndrome after anterior cruciate ligament reconstruction

Abstract

Background Cyclops lesion is the second most common cause of extension loss after anterior cruciate ligament reconstruction. This study focused on the correlation between the anatomy of the intercondylar notch and the incidence of cyclops lesion. To determine whether the size and shape of the intercondylar notch are related to cyclops lesion formation following anterior cruciate ligament reconstruction according to magnetic resonance imaging (MRI) findings. Methods One hundred twenty-five (125) patients were retrospectively evaluated. The notch width index (NWI) and notch shape index (NSI) were measured based on coronal and axial MRI sections in patients diagnosed with cyclops syndrome (n = 25), diagnosed with complete anterior cruciate ligament (ACL) tears (n = 50), and without cyclops lesions or ACL ruptures (n = 50). Results Imaging analysis results showed that the cyclops and ACL groups had lower mean NWI and NSI values than the control group. Significant between-group differences were found in NSI (p = 0.0140) based on coronal cross-sections and in NWI (p = 0.0026) and NSI (p < 0.0001) based on axial sections. Conclusions The geometry of the intercondylar notch was found to be associated with the risk of cyclops lesion formation and ACL rupture.

Graft impingement increases anterior cruciate ligament graft signal more than acute graft bending angle: magnetic resonance imaging‐based study in outside‐in anterior cruciate ligament reconstruction

“…Moreover, it was observed that a narrow notch was a more important factor for increased signal intensity of the entire intra-articular graft, especially at the mid-substance of the graft, which was in accordance with a previous report [39]. Narrow intercondylar notches are associated with greater impingement, which can lead to graft degeneration, and is considered a predictive factor for ACL injury [10,22,37,39]. In the present study, we also analyzed the association of the narrow intercondylar notch with impingement in the reconstructed graft.…”

Bone–patellar tendon–bone autograft and female sex are associated with the presence of cyclops lesions and syndrome after anterior cruciate ligament reconstruction

“…They found that the percentage of the total femoral tunnel size to CSA was significantly higher in the patients with cyclops lesions than in those patients without cyclops lesions. A recent study [10] also indicated that the shape of the intercondylar notch as well as the size was related to cyclops lesion formation after ACL‐R. As the evaluation for the femoral notch using NWI does not take into account the shape of the intercondylar notch or the ACL graft volume in relation to the notch size [18, 33], NWI may not be associated with the presence of cyclops lesions and syndrome in this study.…”

Risk Factors of Loss of Knee Range of Motion after Primary Anterior Cruciate Ligament Reconstruction following Preoperative Recovery of Knee Range of Motion

“…Several authors have reported that femoral intercondylar size and shape were related to the risk of cyclops lesion after ACLR. 14,15,41 However, to the best of our knowledge, no studies have reported the association between morphological factors of tibial spines and loss of knee ROM after ACLR. Iriuchishima et al radiographically evaluated whether or not tibial spine heights, TSW, and NWI were associated with the occurrence of ACL injury, 16 suggesting that a larger TSW may contribute to knee stabilization, which may decrease the risk of ACL injury.…”