Skeletal Radiology

, Volume 41, Issue 8, pp 997–1002 | Cite as

Analysis of cyclops lesions after different anterior cruciate ligament reconstructions: a comparison of the single-bundle and remnant bundle preservation techniques

  • Jihoon Cha
  • Sang-Hee ChoiEmail author
  • Jong Won Kwon
  • Sang-Hak Lee
  • Jin Hwan Ahn
Scientific Article



The aim of this work was to compare the prevalence of cyclops lesions after anterior cruciate ligament reconstruction (ACLR) using the single-bundle and remnant bundle preservation techniques.

Materials and methods

One hundred consecutive patients, who had undergone postoperative MRI of the knee followed by arthroscopic ACLR with the remnant bundle preservation technique (R) between February 2007 and August 2010, were enrolled in this study. Thirty-six consecutive patients who underwent ACLR using the single-bundle technique (S) were also included in this study as a control group. The MR findings were scored based on the presence of pre-ACL graft lesion as 0, 1, 2, or 3 on the sagittal images. The sixty-one specimens by second-look surgery (20 in S, 41 in R) were pathologically examined.


The numbers of patients with scores of 0, 1, 2, and 3 were 1, 18, 14, and 3 in group S and 4, 60, 29, and 7, in group R, respectively. Of the 61 patients who underwent second-look surgery (20 in S, 41 in R), eight had a cyclops lesion (three in group S and five in group R). The prevalence of cyclops lesion was not significantly different in group R and group S (p = 0.761).


The prevalence of a cyclops lesion was similar in both groups.


Knee MRI ACL reconstruction Remnant bundle preservation technique Arthrofibrosis 


  1. 1.
    Casagranda BU, Maxwell NJ, Kavanagh EC, Towers JD, Shen W, Fu FH. Normal appearance and complications of double-bundle and selective-bundle anterior cruciate ligament reconstructions using optimal MRI techniques. AJR Am J Roentgenol. 2009;192(5):1407–15.PubMedCrossRefGoogle Scholar
  2. 2.
    Bach Jr BR, Tradonsky S, Bojchuk J, Levy ME, Bush-Joseph CA, Khan NH. Arthroscopically assisted anterior cruciate ligament reconstruction using patellar tendon autograft. Five- to nine-year follow-up evaluation. Am J Sports Med. 1998;26(1):20–9.PubMedGoogle Scholar
  3. 3.
    Shelbourne KD, Gray T. Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation. A two- to nine-year follow-up. Am J Sports Med. 1997;25(6):786–95.PubMedCrossRefGoogle Scholar
  4. 4.
    Johnson RJ, Beynnon BD, Nichols CE, Renstrom PA. The treatment of injuries of the anterior cruciate ligament. J Bone Joint Surg Am. 1992;74(1):140–51.PubMedGoogle Scholar
  5. 5.
    Harner CD, Giffin JR, Dunteman RC, Annunziata CC, Friedman MJ. Evaluation and treatment of recurrent instability after anterior cruciate ligament reconstruction. Instr Course Lect. 2001;50:463–74.PubMedGoogle Scholar
  6. 6.
    Ochi M, Adachi N, Deie M, Kanaya A. Anterior cruciate ligament augmentation procedure with a 1-incision technique: anteromedial bundle or posterolateral bundle reconstruction. Arthroscopy. 2006;22(4):e461–5. 463.Google Scholar
  7. 7.
    Adachi N, Ochi M, Uchio Y, Iwasa J, Ryoke K, Kuriwaka M. Mechanoreceptors in the anterior cruciate ligament contribute to the joint position sense. Acta Orthopaedica Scandinavica. 2002;73(3):330–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Denti M, Monteleone M, Berardi A, Panni AS. Anterior cruciate ligament mechanoreceptors. Histologic studies on lesions and reconstruction. Clin Orthop Relat Res. 1994;308:29–32.PubMedGoogle Scholar
  9. 9.
    Gohil S, Annear PO, Breidahl W. Anterior cruciate ligament reconstruction using autologous double hamstrings: a comparison of standard versus minimal debridement techniques using MRI to assess revascularisation. A randomised prospective study with a one-year follow-up. J Bone Joint Surg Br. 2007;89(9):1165–71.PubMedCrossRefGoogle Scholar
  10. 10.
    Bradley DM, Bergman AG, Dillingham MF. MR imaging of cyclops lesions. AJR Am J Roentgenol. 2000;174(3):719–26.PubMedGoogle Scholar
  11. 11.
    Mae T, Shino K, Miyama T, Shinjo H, Ochi T, Yoshikawa H, et al. Single- versus two-femoral socket anterior cruciate ligament reconstruction technique: biomechanical analysis using a robotic simulator. Arthroscopy. 2001;17(7):708–16.PubMedCrossRefGoogle Scholar
  12. 12.
    Kim SJ, Jo SB, Kim TW, Chang JH, Choi HS, Oh KS. A modified arthroscopic anterior cruciate ligament double-bundle reconstruction technique with autogenous quadriceps tendon graft: remnant-preserving technique. Arch Orthop Trauma Surg. 2009;129(3):403–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Sbihi A, Franceschi JP, Christel P, Colombet P, Djian P, Bellier G. Anterior cruciate ligament reconstruction: biomechanical comparison on cadaver specimens using a single or double hamstring technique. Rev Chir Orthop Reparatrice Appar Mot. 2004;90(7):643–50.PubMedCrossRefGoogle Scholar
  14. 14.
    Hamada M, Shino K, Horibe S, Mitsuoka T, Miyama T, Shiozaki Y, et al. Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with endoButton femoral fixation: a prospective study. Arthroscopy. 2001;17(8):801–7.PubMedGoogle Scholar
  15. 15.
    Adachi N, Ochi M, Uchio Y, Iwasa J, Kuriwaka M, Ito Y. Reconstruction of the anterior cruciate ligament. Single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br. 2004;86(4):515–20.PubMedGoogle Scholar
  16. 16.
    Ahn JH, Lee YS, Ha HC. Anterior cruciate ligament reconstruction with preservation of remnant bundle using hamstring autograft: technical note. Arch Orthop Trauma Surg. 2009;129(8):1011–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Zimny ML, Schutte M, Dabezies E. Mechanoreceptors in the human anterior cruciate ligament. Anat Rec. 1986;214(2):204–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Adachi N, Ochi M, Uchio Y, Sumen Y. Anterior cruciate ligament augmentation under arthroscopy. A minimum 2-year follow-up in 40 patients. Arch Orthop Trauma Surg. 2000;120(3–4):128–33.PubMedCrossRefGoogle Scholar
  19. 19.
    Arnoczky SP, Tarvin GB, Marshall JL. Anterior cruciate ligament replacement using patellar tendon. An evaluation of graft revascularization in the dog. J Bone Joint Surg Am. 1982;64(2):217–24.PubMedGoogle Scholar
  20. 20.
    Jackson DW, Schaefer RK. Cyclops syndrome: loss of extension following intra-articular anterior cruciate ligament reconstruction. Arthroscopy. 1990;6(3):171–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Marzo JM, Bowen MK, Warren RF, Wickiewicz TL, Altchek DW. Intraarticular fibrous nodule as a cause of loss of extension following anterior cruciate ligament reconstruction. Arthroscopy. 1992;8(1):10–8.PubMedCrossRefGoogle Scholar

Copyright information

© ISS 2011

Authors and Affiliations

  • Jihoon Cha
    • 1
  • Sang-Hee Choi
    • 1
    Email author
  • Jong Won Kwon
    • 1
  • Sang-Hak Lee
    • 2
  • Jin Hwan Ahn
    • 2
  1. 1.Department of Radiology and Center for Imaging Science, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  2. 2.Department of Orthopedic Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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