BACKGROUND Cyclops syndrome is characterized by a symptomatic extension deficit attributed to impingement of a cyclops lesion within the intercondylar notch. The syndrome is an important cause of reoperation after anterior cruciate ligament reconstruction (ACLR). It has been suggested that remnant-preserving ACLR techniques may predispose to cyclops syndrome, but there is very limited evidence to support this. In general terms, risk factors for cyclops syndrome are not well-understood. PURPOSE To determine the frequency of and risk factors for reoperation for cyclops syndrome in a large series of patients after ACLR. STUDY DESIGN Case-control study; Level of evidence, 3. METHODS A retrospective analysis of prospectively collected data was performed, including all patients who underwent primary ACLR between January 2011 to December 2017. Patients undergoing major concomitant procedures were excluded. Demographic data, intraoperative findings (including the size of preserved remnants), and postoperative outcomes were recorded. Those patients who underwent reoperation for cyclops syndrome were identified, and potential risk factors were evaluated in multivariate analysis. RESULTS A total of 3633 patients were included in the study, among whom 65 (1.8%) underwent reoperation for cyclops syndrome. Multivariate analysis demonstrated that preservation of large remnants did not predispose to cyclops lesions (odds ratio [OR], 1.11; 95% CI, 0.63-1.93). The most important risk factor was extension deficit in the early postoperative period. If present at 3 weeks postoperatively, it was associated with a >2-fold increased risk of cyclops syndrome (OR, 2.302; 95% CI, 1.268-4.239; P < .01), which was increased to 8-fold if present 6 weeks after ACLR (OR, 7.959; 95% CI, 4.442-14.405; P < .0001). None of the other potential risk factors evaluated were found to be significantly associated with an increased frequency of cyclops syndrome. CONCLUSION Failure to regain full extension in the early postoperative period was the only significant risk factor for cyclops syndrome after ACLR in a large cohort of patients. Other previously hypothesized risk factors, such as preservation of a large anterior cruciate ligament remnant, did not predispose to the development of this debilitating postoperative complication.

中文翻译：

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术后早期膝关节伸展不足易导致前交叉韧带重建后的独眼巨人综合征：来自SANTI研究组数据库的3633名患者的危险因素分析。

背景技术独眼巨人综合症的特征在于症状性延伸不足，其归因于a间凹口内的独眼巨人病变的撞击。该综合征是前交叉韧带重建（ACLR）后再次手术的重要原因。有人提出，保留残余的ACLR技术可能易患上睫状肌综合症，但仅有极有限的证据支持这一点。一般而言，对睫状肌综合症的危险因素尚不了解。目的确定在ACLR后大量患者中再次发生睫毛综合征的频率和危险因素。研究设计病例对照研究；证据等级，3。方法对前瞻性收集的数据进行回顾性分析，包括2011年1月至2017年12月期间接受原发性ACLR的所有患者。排除接受重大伴随手术的患者。记录人口统计学数据，术中发现（包括保留的残余物的大小）和术后结果。确定那些因睫毛综合症而再次手术的患者，并在多因素分析中评估潜在的危险因素。结果本研究共纳入3633例患者，其中65例（1.8％）因睫毛综合症进行了再次手术。多变量分析表明，保留大量残留物并不易引起睫毛病变（几率[OR]为1.11； 95％CI为0.63-1.93）。最重要的危险因素是术后早期的伸展不足。如果在术后3周出现，则其与睫状肌综合症风险增加> 2倍相关（OR，2.302; 95％CI，1.268-4.239; P <。01），如果在ACLR后6周出现，则增加到8倍（OR，7.959； 95％CI，4.442-14.405； P <.0001）。评估的其他潜在危险因素均未发现与睫毛综合征增加的频率显着相关。结论在大批患者中，术后早期无法完全恢复是ACLR术后唯一的明显危险因素。其他先前假定的危险因素，例如保留大量的前交叉韧带残余物，并不有助于这种使人衰弱的术后并发症的发生。评估的其他潜在危险因素均未发现与睫毛综合征增加的频率显着相关。结论在大批患者中，术后早期无法完全恢复是ACLR术后唯一的明显危险因素。其他先前假定的危险因素，例如保留大量的前交叉韧带残余物，并不有助于这种使人衰弱的术后并发症的发生。评估的其他潜在危险因素均未发现与睫毛综合征增加的频率显着相关。结论在大批患者中，术后早期无法完全恢复是ACLR术后唯一的明显危险因素。其他先前假定的危险因素，例如保留大量的前交叉韧带残余物，并不有助于这种使人衰弱的术后并发症的发生。