Intercondylar notch size influences cyclops formation after anterior cruciate ligament reconstruction

Abstract

Case-control study, Level IV.

Sonographic and Magnetic Resonance Imaging Examination of a Cyclops Lesion After Anterior Cruciate Ligament Reconstruction: A Case Report

“…The MRI is of low to isointense signal intensity in relation to skeletal muscle on both T1-and T2-weighted pulse sequences. [8][9][10][11][12] These MRI findings were consistent with those identified in our patient. The ACL graft fibers are typically seen as a low signal intensity except 4-8 months postoperatively, when the graft may appear iso-to hyperintense on fluid-sensitive imaging (T2, fat suppression) because of revascularization and synovialization.…”

“…1 However, 1 study found that physical therapy and graft placement were not related to the degree of severity of cyclops formation. 3 Fujii et al 9 found that a smaller cross-sectional area of the femoral intercondylar notch post-ACL reconstruction, as measured on MRI, was significant in the formation of cyclops lesions, confirming the importance of adequate notchplasty (surgical enlargement of the intercondylar notch) during ACL reconstruction.…”

“…Cyclops lesions are proliferative fibrous nodules with neovascularity that may be a complication of anterior cruciate ligament (ACL) reconstructions or, rarely, acute ACL injury without reconstruction. [1][2][3][4][5][6][7][8][9][10][11][12] The etiology of these nodules is multifactorial, including iatrogenic bone and cartilage drilling debris or anteriorly positioned graft, ACL stump remnants, partially torn anterior graft fibers, and graft hypertrophy from chronic impingement. 1,2,4 Patients often present with medial joint line pain and loss of full extension of the knee, 1,2,4-10 suggesting cyclops syndrome.…”

Intercondylar Notch Measurement During Arthroscopy and on Preoperative Magnetic Resonance Imaging

“…Many methods of notch size measurements on imaging have been described. 2,[8][9][10] However, most methods have been used to study the relationship of notch size to ACL injury, and few have tried to reproduce arthroscopic measurements. Zeng et al 11 performed a meta-analysis of 16 studies assessing the correlation between intercondylar notch size and the risk of ACL injury.…”

“…However, the methodology in the included studies varied greatly. Some studies measure absolute notch width, 2,9,12,13 whereas others measure notch width relative to the size of the femoral condyles. [14][15][16] Furthermore, different studies have measured these parameters on radiography, MRI, and CT scanning with little standardization.…”