{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T01:04:29Z","timestamp":1792285469792,"version":"4.4.0"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Associated risk factors for the development of cyclops lesions have been little. Investigated, because most previous studies have limited their research to cases with symptomatic cyclops lesions (cyclops syndrome). The purpose of this study was to evaluate the presence of cyclops lesions using magnetic resonance image (MRI) at 6 and 12\u00a0months after anterior cruciate ligament reconstruction (ACL\u2010R), and to investigate the associated risk factors of cyclops lesions and syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis of patients who underwent ACL\u2010R using bone\u2013patellar tendon\u2013bone (BTPB) or hamstring tendon autograft from 2008 to 2017 was conducted. Predictor variables (age, sex, body mass index [BMI], time from injury to ACL\u2010R, preinjury Tegner activity score, graft, meniscal and cartilage injury, and notch width index on MRI for the presence of cyclops lesions and syndrome were analyzed with multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred and fifty\u2010five patients (225\u00a0males and 230 females) were enrolled. One hundred and four patients (22.9%) had cyclops lesions, and all cyclops lesions were detected on MRI at 6\u00a0months post\u2010operatively. In addition, 20 patients (4.4%) had cyclops syndrome which means that these were symptomatic cases. The risk factors for presence of cyclops lesions were BPTB autograft (OR\u2009=\u20092.85; 95% CI 1.75\u20134.63; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and female sex (OR\u2009=\u20092.03; 95% CI 1.27\u20133.25; <jats:italic>P<\/jats:italic>\u2009=\u20090.003). The presence of cyclops syndrome increased with graft (BPTB) (OR\u2009=\u200918.0; 95% CI 3.67\u201388.3; Powered by Editorial Manager<jats:sup>\u00ae<\/jats:sup> and ProduXion Manager<jats:sup>\u00ae<\/jats:sup> from Aries Systems Corporation <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), female sex (OR\u2009=\u20093.27; 95% CI 1.07\u201310.0; <jats:italic>P<\/jats:italic>\u2009=\u20090.038), and increased BMI (OR\u2009=\u20091.21; 95% CI 1.05\u20131.39; <jats:italic>P<\/jats:italic>\u2009=\u20090.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>All cyclops lesions were detected 6\u00a0months after ACL\u2010R, and the majority of them were asymptomatic. BPTB autograft and female sex were the significant risk factors for the presence of cyclops lesions and syndrome. In addition, increased BMI was associated with a higher risk of developing cyclops syndrome. When BPTB autograft is used for a female patient, full active knee extension should be encouraged in the early period after ACL\u2010R to prevent cyclops lesion formation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV, retrospective case series.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-022-07219-5","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T15:02:52Z","timestamp":1668006172000},"page":"2762-2771","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Bone\u2013patellar tendon\u2013bone autograft and female sex are associated with the presence of cyclops lesions and syndrome after anterior cruciate ligament reconstruction"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2646-3391","authenticated-orcid":false,"given":"Tomohiro","family":"Tomihara","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Shimada Hospital 100\u20101 Kashiyama 583\u20100875 Habikino Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8138-5341","authenticated-orcid":false,"given":"Yusuke","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Osaka Metropolitan University Graduate School of Medicine 1\u20114\u20113 Asahi\u2011machi, Abeno\u2011ku 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2454-2771","authenticated-orcid":false,"given":"Kazuya","family":"Nishino","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopaedic Surgery Osaka Metropolitan University Graduate School of Medicine 1\u20114\u20113 Asahi\u2011machi, Abeno\u2011ku 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3314-7215","authenticated-orcid":false,"given":"Masatoshi","family":"Taniuchi","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Shimada Hospital 100\u20101 Kashiyama 583\u20100875 Habikino Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junsei","family":"Takigami","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Shimada Hospital 100\u20101 Kashiyama 583\u20100875 Habikino Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuko","family":"Tsumoto","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Shimada Hospital 100\u20101 Kashiyama 583\u20100875 Habikino Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-242X","authenticated-orcid":false,"given":"Hiroshi","family":"Katsuda","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Shimada Hospital 100\u20101 Kashiyama 583\u20100875 Habikino Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518782454"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102649\u2010y"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010021\u201006443\u20109"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010018\u20102271\u20108"},{"key":"e_1_2_11_6_2","first-page":"14","article-title":"Femoral insertion of the ACL. 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July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no conflict of interest associated with this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study, and all protocols, were approved by our Institutional Ethics Review Board.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients provided informed consent to participate in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent 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