Abstract
PURPOSE: Posterior tibial slope (PTS) and static anterior tibial translation (SATT) are established risk factors for anterior cruciate ligament (ACL) graft rupture and may also be associated with cyclops syndrome. This study aimed to assess whether these anatomical parameters influence the prevalence of cyclops syndrome after ACL reconstruction (ACLR). The hypothesis of the present study was that increased PTS and SATT would facilitate the development of cyclops syndrome. METHODS: Patients aged ≥14 years with a minimum follow-up of 6 years who underwent primary ACLR with hamstring autograft between January 2015 and December 2017 were included. Demographic data, PTS, SATT, concomitant lateral extra-articular tenodesis (LET) and reoperation for cyclops syndrome were recorded. Time from index surgery to arthrolysis was documented, with a minimum follow-up of 6 years. Subgroup analysis regarding PTS, SATT and gender was performed. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors. RESULTS: Of 530 patients included for analysis, 18 (3.4%) developed cyclops syndrome at a mean of 14 ± 9 months postoperatively (range, 6-33 months). Patients with a PTS ≥ 12° had a 4.3% rate of cyclops syndrome compared with 3.2% in those with a PTS < 12° (p = 0.536). Patients with a SATT ≥ 5 mm had a 5.6% rate compared with 2.7% for SATT < 5 mm (p = 0.154). Female patients presented a statistically significant higher prevalence (5.9%) compared with males (1.8%, p = 0.024). Concomitant LET did not demonstrate a protective effect (p = 0.807). Female sex was the only independent predictor of cyclops syndrome (OR, 3.3; 95% CI, 1.2-9.1; p = 0.018). CONCLUSION: This study found no evidence that increased PTS or SATT predisposes to cyclops syndrome after ACLR with hamstring autograft. These preoperative parameters should not alert clinicians to an increased risk of postoperative cyclops syndrome. LEVEL OF EVIDENCE: Level III, retrospective case-control study.