We report the case of an inverted cyclops lesion limiting extension of the knee joint after a four-strand hamstring anterior cruciate ligament (ACL) reconstruction. A lump of scar tissue forms in the knee after ACLR surgery. One case has been reported previously following a bone-tendon-bone reconstruction of the ACL but a similar case has not been reported. Knee Imaging Following Anterior Cruciate Ligament Reconstruction: The Surgeons and Radiologists Perspectives. Notify me of follow-up comments by email. Early return of full extension will reduce your risk of developing a cyclops lesion. Federal government websites often end in .gov or .mil. The case studies are great and it just gives me that edge when treating my own clients, giving them a better treatment. We use cookies so we can provide you with the best online experience. Su EP, Su SL, Valle AG Della. Limitation of extension is one of the complications after anterior cruciate ligament (ACL) reconstruction commonly caused by a cyclops lesion, which is most frequently seen in the anterior aspect of the knee arising near the tibial attachment of the graft. Various terms have been used to describe this pathology including infrapatellar contracture syndrome, synovial fibrosis of the infrapatellar fat pad, scarring of the anterior interval, and patella infera syndrome.12,15,16 Postoperative scarring normally appears as thin linear or spiculated regions of low signal on all sequences with small slightly thickened and more nodular portions found along the route of the arthroscopic portals and at the posterior margin of the fat pad (Figure 9).16 In contrast, symptomatic fibrosis results from more extensive fibrotic changes appearing as thickened and irregular areas of low signal on all sequences, which can greatly reduce the amount of normal fat. Excessive fibrosis of the infrapatellar fat pad can result in altered biomechanics of the anterior knee. This can be a particularly devastating complication that can rapidly lead to osteoarthrosis at the patellofemoral joint if left untreated. All the staff, from Michael the physio, Sato the massage therapist and Matt at reception were wonderful. The great part about this exercise is that it can be performed in a more functional, weight-bearing position. No difference was reported in the overall incidence of complications with the use of the QT versus QTPB grafts, however persistent knee pain was 2.7x greater with use of a soft tissue quadriceps graft. This may be due to a what is termed a Cyclops Lesion. Loss of extension is one of the most common complications following ACL surgery and can be of detriment to functional ability, especially in the athletic population (6). . TECHNIQUE STEPS. 2000 Mar;174(3):719-26. doi: 10.2214/ajr.174.3.1740719. MR Imaging of Knee Arthroplasty Implants. (i.e. The moniker of cyclops lesion was given based on the arthroscopic appearance of the fibrous nodule and vessels that resemble an eye. Featuredin theTop 50 Physical Therapy Blog. Got an MRI done and the report said: Complete rupture of the reconstructed ACL with Cyclops lesion Tear of lateral meniscus Ruptured popliteal cyst Multicomponent chondromalacia Following excision of the lesion and notchplasty, our patient regained full range of movement of the knee. The repaired ACL was intact. So I guess my question is, for those of you who have had a cyclops lesion, does this sound like one or what you went through? Physical therapy is not an effective treatment for a cyclops lesion, other than for short-term symptom relief. An often overlooked code is 29884 Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure), which may be assigned for excision of fibrosis/adhesions/scar due to previous procedures or injuries. FOIA Increased preoperative and postoperative inflammation reflected by swelling, effusion, and hyperthermia also plays an important role in the development of this complication.7,11 On MRI, fibrotic tissue encases the ACL graft and can extend anteriorly into the infrapatellar fat pad and suprapatellar bursa or posteriorly to the posterior joint capsule (Figure 8).7. Orthopedics. Clinical Outcomes After Arthroscopic Release of Patellofemoral Arthrofibrosis in Patients With Prior Anterior Cruciate Ligament Reconstruction. First described in 1990 by Jackson and Schaefer (1), a cyclops lesion is a reasonably common complication following anterior cruciate ligament reconstruction (ACLR), with the majority being benign and asymptomatic (2). Methods: A single-center, retrospective chart review identified 1,902 patients between the ages of 8 and 66 yr who had ACL reconstruction between January 1, 2000, and October 31, 2015. Schroer WC, Berend KR, Lombardi A V., et al. What is your diagnosis? Careers. He offers Online Physiotherapy Appointments for 45. The patient had a range of movement of 5130 post-operatively and at 2 months following excision of the lesion she had full active extension, flexion to 130 and a stable knee with negative Lachman, anterior drawer and pivot shift tests. When cyclops lesions measured more than 10 mm . 2 As a result, orthopaedic surgeons recommend ACL reconstruction in most patients, particularly the young patient who desires a return to a high level of activity. History or limited range of motion knee. My x-ray and Ortho appointment are tomorrow. Sequential sagittal T2-weighted images demonstrate a thickened band of fibrosis along the anterior interval of the knee (arrows). Cyclops lesions are areas of granulation tissue with neovascularization and fibrous tissue formation peripherally, most commonly at the anterolateral aspect of the tibial graft site after ACL reconstruction. An 18 year-old female 5 months after ACL reconstruction with pain and diminished range of motion. Layered Approach to the Anterior Knee: Normal Anatomy and Disorders Associated with Anterior Knee Pain. Limitation of extension is one of the complications after anterior cruciate ligament (ACL) reconstruction commonly caused by a cyclops lesion, which is most frequently seen in the anterior aspect of the knee arising near the tibial attachment of the graft. 73: p. 305-314, Clinical Physiology. If the load is new or progressive, monitor the knee joint for the next 24 hours. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. Cyclops lesions are an unfortunate sequelae of anterior cruciate ligament injury, and are most commonly seen following ACL reconstructions. 10(5): p. 489-500, American Journal of Sports Medicine. 2007. I can squat and lift a lot of weight now with little pain, but my gait is a bit off. ACL Brace, This is not medical advice. Typically a cyclops lesion will occur in the months or years after ACLR surgery, with a greater risk of incidence with greater time since surgery. Clinical history: A 19 year-old male presents with limited range of motion of the knee 8 months following anterior cruciate ligament (ACL) reconstruction and a transtibial pullout repair of the posterior root of the lateral meniscus. No cyclops lesion or scar tissue noticed. Arthroscopy . Based in Australia, he recently acted as the High Performance Manager for the Brisbane Roar Soccer Team who play in the Australian A League. Arthroscopic treatment of the arthrofibrotic knee. Arthroscopy: After an acl reconstruction, there is often an area of bunched up residual acl or graft material called the "cyclops lesion ". Resources. The cyclops lesions had a mean size of 16 12 11 mm, with 90% of them located just anterior to the distal ACL. . Sharkey PF, Lichstein PM, Shen C, Tokarski AT, Parvizi J. Inverted Cyclops Lesion without Extension Block: A Case Report and Literature Review. Physiotherapy was organised for regaining range of movement. As soon as you walk through the door you feel welcome and after my first session with Brad I had no doubts he would get me back to my best . I have been going to pogo for 2 years now. Stiffness After TKR: How to Avoid Repeat Surgery. Together we deliver everything you need to help your clients avoid or recover as quickly as possible from injuries. 22:10901096, Current Orthopaedic Practice. Previous studies reported that after ACL reconstruction, the incidence of joint stiffness was between 4 and 38% [8]. At the end of the procedure the patient had a range of movement of -5 to 140 and negative Lachman, anterior drawer and pivot shift tests. Many of these lesions may go undiagnosed as they do not all present symptomatically. Our case differs from that of Rubin et al2 by the fact that it followed a four-strand hamstring reconstruction of the ACL. 2015 Mar;73(1):61-4. Results Cyclops lesions were found in 25% (28/113), 27% Videos. Went back to surgery in July (delayed 4 months because of covid) and got the meniscus clipped and ACL cleaned up and now Im doing great. In 13 patients without cyclops lesions, the femoral tunnel entered the notch within 2 mm of the intersection of the intercondylar roof and the posterior femoral cortex. Extracapsular fibrosis may also be seen. At least that's one theory. Background. PMC 2019 Oct 16;5(4):442-445. doi: 10.1016/j.artd.2019.09.003. Anterior Cruciate Ligament injuries: Stories, Tips, and Advice for recovery, Press J to jump to the feed. Various other theories were later proposed.2 These included compressive loading, microtrauma, micromotion, partial injury to the ACL graft1,3 and irritation due to impingement. The development of patella baja is made more apparent by comparing current and prior studies by plain film or MRI (Figure 11). Get a free issue of Sports Injury Bulletin when you register. Cyclops lesions can be found in up to 25% of ACL reconstructions at 6 months after surgery. I was reading about them on Google and some of the symptoms line up like the quad not fully coming back, audible clunking or occasional catching like I said when I try to fully extend it sometimes, but I have no loss of extension and can straighten both legs the same. Arthroscopic release of anterior interval adhesions is also successful in relieving pain and restoring range of motion. At least that's one theory. It is believed to be a remnant of the previous ACL stump that had remained during the reconstruction surgery. 11 months post-op here missing a few degrees of extension. Clinically it is reported to have prevalence of 1% to 10 % but magnetic resonance imaging (MRI) studies have shown the physiological changes occurring in about 25% to 47% of cyclops lesions. In severe cases of infrapatellar fat pad arthrofibrosis, fibrosis between the patella, patellar tendon, and tibia can result in severe retraction and tethering of the patella leading to patella baja which may become progressive (patella infera). To provide the highest quality clinical and technology services to customers and patients, in the spirit of continuous improvement and innovation. A cyclops lesion (2.2 1.4 2.4 cm) was seen anterior to the ACL in the . i didn't have a cyclops lesion specifically, but i did have scar tissue buildup and needed an MUA & scoping 9 weeks post-op from the initial recon (hammy ACL graft + meniscal stitch). Torn anterior ACL graft fibers remain continuous with the graft in the tibial tunnel and are folded anteriorly (arrows) resulting in a pseudocyclops lesion. Calcification of the fat pad may be present and visible on plain radiographs.1 The MRI findings include severe scarring in the infrapatellar fat pad and progressive patella baja. 25(6), 2009: 626-631, Knee Surg, Sports Traumatol, Arthroscopy, 1992. New posts. 35(8): 1269-1275. The cyclops lesion, also known as localized anterior arthrofibrosis, is a painful anterior knee mass that arises as a complication of anterior cruciate ligament (ACL) reconstruction, although has rarely been reported in patients with ACL injuries that have not been reconstructed. 2001 Feb;17(2):E8. Complications following primary ACLR using quadriceps tendon autograft were recorded in 10.5% of knees, with persistent knee pain being most common. This has since been debated however the two surgeons were actually able to reduce their incidence of cyclops lesions by leaving less debris in the joint post-surgery (7). Never miss a podcast or blog post when you subscribe to our weekly newsletter. The functionality is limited to basic scrolling. This is part of the screw-home mechanism or that locked out feeling you get when you straighten your knee. SARMS. J Chiropr Med. Going. Unresolved deficits warrant further intervention including manipulation under anesthesia, arthroscopic debridement, and open debridement. After briefly reviewing relevant normal ACL anatomy, we will review imaging findings of congenital ACL . The site is secure. Gandhi R, De Beer J, Leone J, Petruccelli D, Winemaker M, Adili A. Predictive risk factors for stiff knees in total knee arthroplasty. Incidentally noted is a hemarthrosis (11B) (with joint fluid appearing hyperintense to muscle) associated with an intra-articular fracture of the posterior tibia (asterisk). Patellar clunk syndrome results from localized fibrous tissue forming at the quadriceps insertion on the proximal pole of the patella and can be seen in up to 3.5% of posterior-stabilized TKAs.23 Patients present with a locking sensation or decreased motion during flexion and extension.17 An audible clunk may be observed on physical exam when the knee is extended from the flexed position, presumably from entrapment of the tissue in the intercondylar notch with flexion and abrupt displacement with extension (Figure 14). Petsche, T. S., & Hutchinson, M. R. (n.d.). Early pool work also provides hydrostatic pressure to aid with effusion drainage. When I mention the word cyclops it might conjure visions of a giant one-eyed beast from your nightmares but this type of cyclops is more of a physiotherapists nightmare. Houston Methodist Orthopedics & Sports Medicine. However it can be an issue for years post-op. The cyclops lesions had a mean size of 16 x 12 x 11 mm, with 90% of them located just anterior to the distal ACL. In: Doral M, Karlsson J, eds. Anatomical location of the ACL and what a torn ACL looks like (right). Home. nerve entrapment and posterior thigh pain, Hip, hip, hooray! Stump Entrapment of the Torn Anterior Cruciate Ligament. doi:10.1148/rg.e26, Sonnery-Cottet, B., Lavoie, F., Ogassawara, R., Kasmaoui, H., Scussiato, R. G., Kidder, J. F., & Chambat, P. (2010). An 18 year-old female college athlete presents 6 months following ACL reconstruction with locking and catching. Tonin et al reported it in patients with ACL injury without reconstruction surgery.4 In the absence of surgery, the origin was thought to be due to avulsion of pieces of bone from the attachment of the ligament. The infrapatellar fat pad is richly innervated and is an important pain generator in the knee.14 Surgical and traumatic insults to the infrapatellar fat pad can induce fibrosis and metaplasia resulting in pain (September 2008 Web Clinic Patellar Fat Pad Abnormalities).13,14. Most of these reports are based on single-bundle ACL reconstruction. In this video, I explain the signs and symptoms associated with cyclops lesions after ACL surgery. "The procedure to repair a torn ACL is called a reconstruction, and the torn ligament is replaced with a tendon. It is a lesion consisting of fibrous. Lock & unlock your knee, not letting it flick or flop back to straight. In a long-sit position place a towel or band around your foot. Our international team of qualified experts (see above) spend hours poring over scores of technical journals and medical papers that even the most interested professionals don't have time to read. Concerns of emerging arthrofibrosis should be raised if physical therapy fails to achieve expected range of motion targets following surgery. Cyclops lesions occur in the minority of cases of ACLR surgery, between 1-10%. This is not medical advice. Clinical and Operative Characteristics of Cyclops Syndrome After Double-Bundle Anterior Cruciate Ligament Reconstruction. On MRI, nodular or band-like synovial thickening or intra-articular masses demonstrate low to intermediate signal on proton-density and T2-weighted images (Figure 13). Examination under anaesthesia revealed positive Lachman and anterior drawer tests (both showing 510mm of anterior displacement of the tibia) as well as a positive pivot shift test. So just wanted to add that it seems like scar tissue can maybe still be an issue even if it doesn't form a true cyclops. Ann R Coll Surg Engl. Fibrosis in the suprapatellar bursa typically limits knee flexion. ACL Rehab Exercises (2B) On the T1-weighted sagittal image, the nodular focus anterior to the ACL (arrow) is heterogeneous but almost isointense to the joint fluid and articular cartilage with subtle central areas of reduced signal. Abreu MR, Chung CB, Trudell D, Resnick D. Hoffas fat pad injuries and their relationship with anterior cruciate ligament tears: New observations based on MR imaging in patients and MR imaging and anatomic correlation in cadavers. Arthroscopic treatment of patellar clunk. between patients with and without cyclops lesion. Its an important aspect of creating a stable knee and a lack of extension puts added stress on the quadriceps muscles and patellofemoral joint (under the knee cap) (1). Apply a low load on top of the knee and hold this for a prolonged period e.g 15 minutes. It was first described in patients with ACL reconstruction [1] but recently it has been reported cases without this antecedent [2]. It is not an actual Cyclops lesion as it is a torn ACL instead of fibrotic tissue. What are the findings? I would highly recommend pogo physio. We recommend a consultation with a medical professional such as James McCormack. Continued or recurrent tear of medial meniscus. Movies available at http://radiographics.rsnajnls.org/cgi/content/full/e26/DC1. I told the doctor about that but was unable to reenact it for him as it only happens sometimes. Many authors recommend arthroscopic debridement prior to manipulation under anesthesia to mitigate the risk of fracture, chondral damage, intra-articular hemorrhage, and ligament or tendon rupture. New media New comments. 3. The scarred synovium is hypointense to muscle on proton density-weighted and T2-weighted MR images (Figure 12).17. Related Articles: The cyclops lesion is a localized anterior arthrofibrosis most commonly seen following anterior cruciate ligament reconstruction. This was excised arthroscopically (Fig 2). Factors that are felt to increase the likelihood of diffuse arthrofibrosis include ACL reconstruction within 4 weeks of the ACL injury, additional ligamentous injuries, and diminished knee flexion preoperatively. You may notice problems with Srinivasan R, Wan J, Allen CR, Steinbach LS. 48 year-old male with sagittal T1-weighted images at the time of the ACL tear (11A) and 2 years later after a fall (11B) demonstrates the development of severe scarring within the infrapatellar fat pad and posterior to the patellar tendon with interval inferior displacement of the patella. Bencardino JT, Beltran J, Feldman MI, Rose DJ. ACL Injuries in Sport Facchetti L, Schwaiger BJ, Gersing AS, et al. The tract of the transtibial pullout repair extends obliquely through the tibia (arrowheads). The axial proton density-weighted image (13B) reveals this structure to be a band-like region of arthrofibrosis (arrowheads) passing posterior to the patella and blending with the synovium medial and lateral to the patella, likely contributing to the patients mechanical symptoms. Methods After we performed prospective power analysis and obtained institutional review board approval, as well as patient consent, 64 patients were block randomized among 3 study sites to the aperture fixation group or . Not only the best in the business in regards to diagnosing and treating injuries but have created and built up over time a very rare form of community and environment that makes you feel welcomed, valued and overall like you apart of something bigger than just getting treatment on an injury. I'm about a year and a half post op with a hamstring graft, and I recently saw my surgeon about a lingering issue in my knee involving a sharp pain that feels like it's inside the kneecap. ACL grafts are very strong. The appearance and clinical history are suggestive of patellar clunk syndrome. Sequential sagittal proton-density weighted images demonstrate loss of ligament tissue anteriorly (arrowheads) within the intercondylar notch compatible with a partial tear. For those not familiar, a cyclops lesion is a wad of scar tissue in the anterior aspect of the knee joint. Initially, a more aggressive physical therapy regimen is attempted along with anti-inflammatory medications. The mechanisms are thought to be similar to the post-surgery presentation (7). Why Are Total Knee Arthroplasties Failing Today-Has Anything Changed After 10 Years? A focus of soft tissue thickening is compatible with a small cyclops lesion anterior to the graft (arrowhead). MR imaging showed a well-defined, somewhat heterogeneous soft-tissue nodule with a signal intensity typically similar to that of skeletal muscle. 2016 Sep;15(3):214-8. doi: 10.1016/j.jcm.2016.06.003. In general, an inciting trauma, surgery, or infection results in a healing response which includes the migration of inflammatory cells and the proliferation of fibroblasts followed by the release of cytokines, growth factors, and reactive oxygen and nitrogen species.1 Failure to terminate the healing response normally results in persistent inflammation of the synovial tissue with increased inflammatory cytokines and certain growth factors that trigger tissue fibrosis via the transformation of fibroblasts.1 Fibroblast proliferation results in the accumulation of increased extracellular matrix which impairs blood flow and results in local hypoxia. I cannot thank you all enough. I had an MRI done a few weeks ago and the results were obnoxious vague. Richmond JC, Al Assal M. Arthroscopic Management of Arthrofibrosis of the Knee, Including Infrapatellar Contraction Syndrome. A 40 year-old female who underwent revision TKA 1 year prior presents with catching and locking symptoms anteriorly when going from 90 degrees of flexion to full extension. Possible problems that can lead to the re-tear of the ACL include suboptimal positioning of the graft, improper tension on the graft, or failure of the fixation of the graft. Arthroscopic Release for Symptomatic Scarring of the Anterior Interval of the Knee. Fig. Another study reported an incidence of 47% within the first year, though symptoms were only present for about 10% of these cases (Kambhampati et al, 2020). It is named accordingly due to its appearance, as during surgical removal of the lesion it looks like the eye of a cyclops. We present 2 cases (3 knees) in which cyclops lesions appeared atypically following bicruciate-retaining total . The https:// ensures that you are connecting to the One common complication of ACL reconstruction is a limited range of motion, especially obtaining a fully straight knee. Reconstruction of the anterior cruciate ligament (ACL) is a commonly performed procedure that produces reliable and reproducible outcomes [1], [2], [3].Although the post-operative complication rate is low, loss of knee extension may require revision surgery [4], [5], [6], [7].Cyclops syndrome was first described in 1990 by Jackson and Schaefer as loss of full knee extension . 2011, 22(4). Bone and Joint Clinic. For those not familiar, a cyclops lesion is a wad of scar tissue in the anterior aspect of the knee joint. Loss of full extension after anterior cruciate ligament (ACL) reconstruction, with development of an audible and palpable "clunk" with terminal extension was first described by Jackson and Schaefer as "cyclops syndrome." Women have a higher risk, as the intracondylar notch is narrower. Steadman JR, Dragoo JL, Hines SL, Briggs KK. Similar signal characteristics are noted at the posterior margin of the infrapatellar fat pad. Different aspects of the cyclops lesion following anterior cruciate ligament reconstruction: A multifactorial etiopathogenesis. Click on the banner to find out more. Podcast. Cyclops lesions are located just above the tibial tunnel and cause loss of knee range of motion with a mechanical block that restricts getting the leg completely straight following surgery. Would you like email updates of new search results? MR Imaging of Cyclops Lesions. No stones are left unturned in their pursuit for their patients physical best. The authors suspect that the cause of cyclops lesions that occur in the absence of ACL reconstruction is similar to that suggested in the classic postoperative patient. This was not the same as the snap as the first year but I felt like something was off. Kambhampati, MS (Ortho), FRCS (Eng & Glasg), FRCS (Trauma & Orth), Dip (Applied Biomech), Srikanth Gollamudi, MS (Ortho), FRCS, Saseendar Shanmugasundaram, MS (Ortho), DNB (Ortho), Dip SICOT (Belgium), and Vidyasagar V.S. Fritz J, Lurie B, Potter HG. Steroid Profiles. Focal areas of fibrosis following TKA are often seen in the peripatellar region and can present with mechanical symptoms. 8600 Rockville Pike The cyclops lesion after bicruciate-retaining total knee replacement. When I try to really squeeze it straight with my quad I can get close but I feel a pinch underneath the kneecap. Sports med doc said it's likely inoperable, but offered no solutions. It was located in the anterior part of the roof of the notch and extended deeper into the notch towards the ACL graft. Assessment of the type of deficit is important in directing the therapeutic approach. The patient was otherwise fit and well. Best of luck though. Clinical evaluation is the mainstay in establishing the diagnosis of arthrofibrosis, however MRI plays an important role in establishing the extent of involvement by fibrosis and to exclude other complications that may have a similar clinical presentation. 2017 October ; 35(10): 22752281, Annals of Rheumatic Diseases, 1993. Cyclops syndrome is caused by a scar tissue nodule adjacent to the tibial tunnel of the anterior cruciate ligament graft after surgery. MR Imaging of Complications of Anterior Cruciate Ligament Graft Reconstruction. Press question mark to learn the rest of the keyboard shortcuts. A 60 year-old male 4 years post TKA complains of pain and popping of the knee with walking for the last 6 weeks. Also, moving your knee in & out of terminal extension helps develops hamstring and quadriceps control which can be lacking post-injury. This site needs JavaScript to work properly. "1. MRI findings of cyclops lesions of the knee. The American Journal of Sports Medicine 2020;48(3):565572, Knee Surg Sports Traumatol Arthrosc. 5-7,9 However, a cyclops lesion can be found in asymptomatic patients . If you have decided that surgery is the best option, we take a look at the options for reconstruction and assess the pros and cons. When it comes to ACL reconstruction surgery, there are some options. The goal of surgery is to prevent joint instability, which may further damage articular cartilage and menisci. Unfortunately, physiotherapy isnt able to help your cyclops lesion. SA Orthopaedic Journal, 11(2). A sagittal T2-weighted image demonstrates prominent peripatellar scarring in the infrapatellar fat pad (asterisk) and above the patella with a nodular component extending inferiorly at the posterior margin of the superior patella (arrows). Sometimes when patients undergo reconstruction surgery of their Anterior Cruciate Ligament (ACL) they have issues with achieving full extension (straightening) of the knee. From 2001 to 2006, the authors identified 10 patients (five women and five men, ages 27-76 years) with cyclops nodules seen at magnetic resonance (MR) imaging. Thanks Pogo Physio! A 15 year-old female who is 4 months post ACL reconstruction with knee pain and stiffness. All patients had a history of trauma but no history of ACL reconstruction. The anterior interval of the knee is found posterior to the patellar fat pad and anterior to the anterosuperior tibial plateau.2 Scarring over the posterior aspect of the infrapatellar fat pad from the patella to the anterior surface of the tibia or the transverse meniscal ligament can bridge the interval and result in restriction of the normal biomechanics of the anterior knee with increased tension on the fat pad, diminished translation of the patellar tendon and patellar entrapment (Figure 10).15. A 32 year-old male 3 years post-ACL reconstruction with anteromedial knee pain. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 8(1), 10-18. doi:10.1016/0749-8063(92)90129-y, Minne, C., Velleman, & Sulleman, F. E. (2012). Cyclops syndrome due to a lesion of the anterior cruciate ligament, Fixed flexion deformity of the knee following femoral physeal fracture: the inverted cyclops lesion.
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