半腱肌腱和股薄肌腱重建前交叉韧带后Cyclops综合症临床研究

目的:研究采用自体半腱肌腱和股薄肌腱重建前交叉韧带(ACL)后膝关节内Cyclops综合症的发生情况。方法:回顾性研究2004~2005年197例采用半腱肌腱和股薄肌腱重建ACL后取出内固定患者,平均年龄25.85岁。取内固定时通过病史、体征、X线及KT-2000评估膝关节功能,手术同时进行膝关节镜探查,观察关节内髁间窝增生物情况,并进行统计分析。结果:所有患者中发现有髁间窝结节样增生物(统称为Cyclops病变)形成28例,其中2例伴有伸膝受限(同健侧膝关节比较),Cyclops综合症的发生率为1.02%(2/197)。无Cyclops病变的患者中伸膝受限5例。根据是否存在Cyclops病变将所有患者分为Cyclops组和非Cyclops组,两组伸膝受限发生率的差异无统计学意义(2χ=0.268)。Cyclops病变的病理表现为增生变性的瘢痕样组织,无骨性成分。Cyclops组患者取钉时KT-2000检查结果显示134N下差值平均为1.8mm,有24例均恢复到原来的运动水平。结果表明,采用半腱肌腱和股薄肌腱重建前交叉韧带后Cyclops病变发生率较高,但产生伸膝受限(Cyclops综合症)的发生率低。

Cyclops Syndrome after Reconstruction of Anterior Cruciate Ligament with Semitendinosus and Gracilis Tendon

Objective To investigate the occurrence of Cyclops syndrome after anterior cruciate ligament(ACL) reconstruction with semitendinosus and gracilis tendon.Methods One hundred and ninety seven cases with ACL reconstruction after removing the internal fixation from 2004 to 2005 were studied retrospectively.The average age of the patients was 25.85 years.The knee function before operation were evaluated through symptoms,x-ray and KT-2000. Cyclops lesion was observed by arthroscopy.Results Limited knee extension was found in 7 cases.Nodulous formation at intercondylar fossa(Cyclops lesion) was found in 28 cases,in which there were 2 cases with limited knee extension(as compared with the contralateral knee).Incidence of Cyclops syndrome was 1.02%.All cases were divided into Cyclops group and non-Cyclops group,and the incidence of limited knee extension between the two groups was not statistically difference(χ2=0.268).Scar tissue was the pathological change of Cyclops lesion.KT-2000 test under 134N showed that the difference of patients with Cyclops syndrome was 1.8mm.24 cases in Cyclops group regained their primary athletic level.Conclusion The incidence of Cyclops syndrome after ACL reconstruction with semitendinosus and gracilis tendon was very low. Scar tissue was essentially the lesion of Cyclops syndrome.