Cyclops lesions detected by MRI are frequent findings after ACL surgical reconstruction but do not impact clinical outcome over 2 years

Eur Radiol. 2017 Aug;27(8):3499-3508. doi: 10.1007/s00330-016-4661-3. Epub 2016 Dec 16.

Abstract

Objectives: To assess the impact of cyclops lesions with MRI in patients treated for anterior cruciate ligament (ACL) tears on clinical outcome.

Methods: In 113 patients (age 29.8 ± 10.5y; 55 females; BMI 24.8 ± 3.7 kg/m2) with complete ACL tear, 3 T-MRI scans were obtained before, 6-months, 1-year (n = 75) and 2-years (n = 33) after ACL reconstruction. Presence and volume of cyclops lesions were assessed. Clinical outcomes were measured using the Knee injury and Osteoarthritis Outcome Score (KOOS) and differences between time points (∆KOOS) were calculated. Changes of KOOS subscales were compared between patients with and without cyclops lesion. KOOS was also correlated with lesion volume.

Results: Cyclops lesions were found in 25% (28/113), 27% (20/75) and 33% (11/33) of patients after 6-months, 1- and 2-years, respectively. The lesion volume did not change significantly (P > 0.05) between time points, measuring 0.65 ± 0.59, 0.81 ± 0.70 and 0.72.9 ± 0.96 cm3, respectively. Clinical outcomes based on KOOS subscales were not significantly different in patients with cyclops lesions compared to those without cyclops lesions (each comparison P > 0.05), and no significant associations of clinical outcomes with lesion volume were found (P > 0.05).

Conclusions: Neither presence nor size of cyclops lesions within the first 2-years after ACL surgery were associated with inferior clinical outcome.

Key points: • Cyclops lesions had a prevalence of 25% in patients after ACL reconstruction. • Subjects with cyclops lesions did not have an inferior clinical outcome. • Cyclops lesions developed within the first 6 months after surgery. • The size of cyclops lesions did not significantly change over a period of 2 years.

Keywords: Anterior cruciate ligament tear; Clinical outcome; Cyclops lesions; KOOS score; MRI.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / diagnostic imaging
  • Anterior Cruciate Ligament / pathology*
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries / diagnostic imaging*
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Female
  • Fibrosis
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Knee Joint / pathology
  • Longitudinal Studies
  • Magnetic Resonance Imaging / methods
  • Male
  • Postoperative Period
  • Prognosis
  • Reproducibility of Results
  • Severity of Illness Index
  • Young Adult