Purpose
To determine factors associated with localized anterior arthrofibrosis (cyclops lesion),
such as graft size, warranting early reoperation for lysis of adhesions after anterior
cruciate ligament reconstruction (ACLR) with all–soft tissue quadriceps tendon (ASTQT)
autograft.
Methods
All primary ASTQT autograft ACLRs within a single surgeon’s prospectively collected
registry with minimum 6-month follow-up were included. Patients who underwent multiligament
knee reconstruction or cartilage restoration procedures were excluded. Localized anterior
arthrofibrosis was defined as the requirement for a second procedure to achieve debridement
and lysis of adhesions owing to the inability to regain terminal extension within
6 months of ACLR. The sex-specific incidence of arthrofibrosis was evaluated relative
to age, weight, femoral and tibial tunnel sizes, meniscal repair, and meniscectomy
by a binary logistic regression.
Results
This study included 721 patients (46% female patients). There were 52 cases of localized
anterior arthrofibrosis (7.2%). Female patients had a greater incidence of arthrofibrosis
than male patients. Male patients with a femoral tunnel diameter of 9.25 mm or greater
had an increased incidence of arthrofibrosis compared with those with a diameter of
less than 9.25 mm, whereas a similar cutoff was not found to be statistically significant
for female patients. Concomitant meniscal repair was associated with an increased
risk of arthrofibrosis.
Conclusions
Female sex and concomitant meniscal repair were associated with an increased localized
anterior arthrofibrosis incidence. Furthermore, ASTQT with a femoral tunnel diameter
of 9.25 mm or greater in male patients was associated with an increased incidence
of arthrofibrosis.
Level of Evidence
Level III, retrospective, comparative prognostic trial.
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Article info
Publication history
Published online: December 28, 2022
Accepted:
November 13,
2022
Received:
March 15,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
R.M.H. and J.D.L. contributed equally to this work.
The authors report the following potential conflicts of interest or sources of funding: J.D.L. receives research support from Arthrex and consulting fees from Mitek, outside the submitted work. J.W.X. is a consultant for Arthrex and Trice Medical and receives royalties from Arthrex, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
