From the Guidelines
Treatment for a cyclops lesion typically involves arthroscopic surgical removal of the fibrous nodule that has formed in the knee joint, usually after anterior cruciate ligament (ACL) reconstruction, as this approach has been shown to be effective in resolving symptoms and restoring knee function 1.
Key Considerations
- The procedure, called arthroscopic debridement, removes the cyclops lesion that is blocking full knee extension, and is generally recommended when conservative treatments fail to resolve symptoms of pain, limited knee extension, and clicking or locking sensations.
- During the procedure, the surgeon will identify and excise the fibrous nodule, clear any remaining debris, and ensure full range of motion is restored.
- Physical therapy is essential following surgery, focusing on regaining full extension, strengthening the quadriceps muscle, and gradually returning to normal activities.
Rehabilitation and Outcomes
- The rehabilitation protocol typically lasts 4-6 weeks, with progressive exercises to restore function.
- Surgery is highly effective, with most patients regaining full knee extension and experiencing significant pain relief.
- Cyclops lesions form due to an inflammatory response to tissue debris or graft material after ACL reconstruction, creating a mechanical block to knee extension that cannot resolve without removal of the obstructing tissue.
Diagnostic Considerations
- While radiographs and MRI can be used to diagnose and characterize OCD lesions, including cyclops lesions, the decision to proceed with surgery is often based on clinical symptoms and the failure of conservative treatments 1.
- The use of MRI can provide additional information to guide therapeutic decision making, but its incremental diagnostic value in the setting of known OCD determined by radiograph is not well established 1.
From the Research
Treatment Options for Cyclops Lesion
- Arthroscopic debridement is an effective treatment for cyclops syndrome, as seen in studies 2, 3, 4, 5
- Surgical excision is also a management option for symptomatic lesions, with good outcomes and rare recurrence 3, 6
- Conservative management may be used for asymptomatic cyclops lesions 3
- Physical therapy, including an algorithmic approach to rehabilitation, can be beneficial in gaining symmetrical knee extension range of motion and improved function after arthroscopic debridement 4
Diagnosis and Identification
- Magnetic resonance imaging (MRI) is used to diagnose cyclops lesions 3, 6
- Clinical examination can also identify cyclops lesions 6
- The presence of a cyclops lesion should be considered when loss of full extension persists for 2 months after anterior cruciate ligament disruption despite aggressive rehabilitation 5
Characteristics and Risk Factors
- Cyclops lesion is a localized anterior arthrofibrosis that can cause a painful extension block between the femoral intercondylar notch and tibial plateau 2
- Female sex, greater graft volume, bony avulsion injuries, excessively anterior tibial tunnel, double-bundle ACLR, and bicruciate-retaining arthroplasty may predispose patients to cyclops lesions 3