Clinical and Operative Characteristics of Cyclops Syndrome After Double‐Bundle Anterior Cruciate Ligament Reconstruction
Bibliographic record
Abstract
PURPOSE: The purpose of this study was to investigate the clinical and operative characteristics of cyclops lesion in a consecutive series of patients with anterior cruciate ligament (ACL) double-bundle reconstruction. METHODS: Included were 387 patients who underwent an ACL double-bundle reconstruction with quadriceps or hamstring tendons and were followed up at 6 weeks and 3, 6, and 12 months for clinical examination. When a persistent extension deficit was observed 3 months postoperatively, magnetic resonance imaging was performed to eventually diagnose a cyclops syndrome, and arthroscopic removal of the nodule was performed in these cases. The aspect of the nodule was explored before debridement. These patients were reviewed at a mean follow-up of 12 months (minimum, 6 months; maximum, 20 months) after nodule debridement for evaluation. RESULTS: There were 14 patients who had cyclops syndrome (3.61%); 10 cases (5.37%) occurred in the quadriceps tendon group and 4 cases (1.99%) in the hamstring tendon group. In the postoperative period these patients had a mean loss of extension of 6° (range, 5° to 15°), and 78.6% had pain and/or swelling. At the 6-week follow-up, 78.6% of the 14 patients had a significant quadriceps dysfunction associated with an active extension deficit. During arthroscopic debridement, the cyclops lesion was always located on the roof of the intercondylar notch. At the last follow-up, 12 patients had full range of motion, but an extension loss was still present in 2 patients. On the International Knee Documentation Committee objective evaluation, 78.5% of patients were graded A, 14.3% were graded B, and 7.2% were graded C. CONCLUSIONS: Cyclops syndrome after double-bundle ACL reconstruction was more frequently observed with quadriceps tendon graft than with hamstring graft. Its unique characteristic is that the nodule localization is from the roof of the intercondylar notch. The majority of the patients with cyclops syndrome presented with a significant quadriceps dysfunction and an active extension deficit in the immediate postoperative period. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".