Knee Extension Deficit in the Early Postoperative Period Predisposes to Cyclops Syndrome After Anterior Cruciate Ligament Reconstruction: A Risk Factor Analysis in 3633 Patients From the SANTI Study Group Database
| Autor: | Charles Pioger, Jean-Romain Delaloye, Adnan Saithna, Lionel Helfer, Jozef Murar, Florent Franck, Bertrand Sonnery-Cottet, Thais Dutra Vieira |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Anterior cruciate ligament reconstruction Knee Joint medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Minocycline Knee extension Cyclops Lesion 03 medical and health sciences 0302 clinical medicine Postoperative Complications Risk Factors medicine Humans Orthopedics and Sports Medicine Postoperative Period Risk factor Anterior Cruciate Ligament Range of Motion Articular Retrospective Studies 030222 orthopedics biology Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries 030229 sport sciences Recovery of Function Plastic Surgery Procedures biology.organism_classification Surgery Treatment Outcome Case-Control Studies medicine.symptom business Factor Analysis Statistical |
| Zdroj: | The American journal of sports medicine. 48(3) |
| ISSN: | 1552-3365 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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