Welcome to Overtime with the Sports Docs. Today, we’re talking about Cyclops Syndrome after ACL reconstruction surgery. We review an article published in this month’s issue of AJSM titled “Risk Profile for Cyclops Syndrome Necessitating Reoperation After Anterior Cruciate Ligament Reconstruction.” But first, let’s back up a bit and discuss the basics, starting with what Cyclops Syndrome is.

Cyclops syndrome is when a fibrous nodule — the so-called “cyclops lesion” — forms in front of the ACL graft, usually leading to a loss of terminal extension – or reaching full straightening of the knee. Clinically, athletes can’t fully straighten the knee; you may feel a mechanical block or audible clunk; and also feel their gait or running pattern is disrupted.

So, Dr. Ting Cong and colleagues at UPMC analyzed 1,163 primary ACL reconstructions performed between 2014 and 2021. Average patient age: about 25 years. They looked at surgical, anatomic, and patient-specific variables — everything from graft type and diameter to notch width, posterior tibial slope (PTS), tunnel position, remnant preservation, and even contralateral knee hyperextension.

They wanted to define a risk profile — who’s more likely to need that second surgery for a symptomatic cyclops lesion. Listen to learn all about their findings!