高体重指数、术后支具固定、股骨髁间窝狭窄及胫骨隧道前移是前交叉韧带重建术后Cyclops综合征的独立危险因素
简介
本研究回顾性分析了2018-2022年间588例接受初次ACL重建的患者，旨在探究Cyclops综合征的发生率及相关风险因素。结果显示，有症状的Cyclops综合征发生率为10.2%（60例），其中6%（35例）需二次关节镜探查手术。多因素分析确定了四个独立风险因素：**术后使用支具**（OR 2.41）、**更高的BMI**（OR 1.09）、**更窄的股…
英文摘要
INTRODUCTION: Cyclops syndrome consists of the development of a fibrous nodule anterior to the anterior cruciate ligament (ACL) graft resulting in femoral notch impingement with subsequent loss of knee extension and pain. The present study aims to investigate the incidence of cyclops syndrome in a Middle East population and to identify demographic, surgical and radiological risk factors. METHODS: In this retrospective study, patients who underwent primary ACL reconstruction in a single institution between 2018 and 2022 were consecutively included. Symptomatic cyclops lesions (Cyclops syndrome) were defined as the presence of fibrous tissue anterior to the graft (magnetic resonance imaging) associated with pain and/or lack of knee extension. Several demographic, surgical and radiological variables were examined, among them: sex, body mass index (BMI), time injury to surgery, graft type and diameter, addition of lateral extra-articular procedure (LEAP), pre-operative activity level, meniscal lesions and treatments, bracing, deep venous thrombosis prophylaxis, tibial slope, femoral notch size, tibial tunnel positioning. The overall incidence and reoperation rate for cyclops were estimated. A Multivariate logistic regression model was used to identify risk factors and calculate odds ratios and confidence intervals for the single variables. RESULTS: 588 patients were included in the final analysis. Symptomatic cyclops lesions were seen in 60 patients (10.2%); the main symptoms leading to the diagnostic MRI were lack of extension (n=27; 45%), pain (n=29; 50%), and a combination of both (n=3; 5%). 35 (6%) patients were reoperated. The final identified independent risk factors were brace usage (p=0.016; OR 2.41, 95% CI 1.18-4.94), higher BMI (p=0.007; OR 1.09, 95% CI 1.02-1.16), narrower notch apex (p<0.001, OR 0.77, 95% CI 0.67-0.89) and anterior tibial tunnel positioning (p<0.001, OR 4.15, 95% CI 2.17-7.96). CONCLUSION: The incidence of cyclops syndrome in a cohort of patients in the Middle East is approximately 10.2% of primary ACL reconstructions, with a reoperation rate of around 6%. Identified risk factors included a higher BMI, the use of a brace after surgery, narrower notch apex, and anterior tibial tunnel position. No significant influence was observed for posterior tibial slope, sex, graft type and diameter, recourse to LEAP and pre-operative activity level. LEVEL OF EVIDENCE: III (cohort study).