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Excision of a Knee Cyclops Lesion Using a Needle Arthroscope.

ABSTRACT: After anterior cruciate ligament (ACL) reconstruction surgery, achieving full range of motion and strength of the postoperative knee is critical for optimal surgical outcomes. Abnormal tissue growth and scar formation in the postoperative knee can create a block to terminal extension of the knee. Cyclops lesions are areas of granulation tissue with neovascularization and fibrous tissue formation peripherally, most commonly at the anterolateral aspect of the tibial graft site after ACL reconstruction. When these lesions block terminal extension and cause mechanical symptoms, cyclops syndrome is diagnosed, and secondary knee arthroscopy is often performed to remove this tissue to allow for full range of motion. This Technical Note describes a minimally invasive approach with the NanoScope. The NanoScope allows for decreased postoperative pain and swelling with a likely quicker recovery back to normal postoperative therapy.

SUBMITTER: Lavender C

PROVIDER: S-EPMC9051894 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Excision of a Knee Cyclops Lesion Using a Needle Arthroscope.

Lavender Chad C Taylor Shane S Blickenstaff Baylor B Macaskill Micah M Baria Michael M

Arthroscopy techniques 20220316 4

After anterior cruciate ligament (ACL) reconstruction surgery, achieving full range of motion and strength of the postoperative knee is critical for optimal surgical outcomes. Abnormal tissue growth and scar formation in the postoperative knee can create a block to terminal extension of the knee. Cyclops lesions are areas of granulation tissue with neovascularization and fibrous tissue formation peripherally, most commonly at the anterolateral aspect of the tibial graft site after ACL reconstruc ...[more]

PMID: 35493052

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Project description:The advent of arthroscopy in shoulder surgery has allowed for the development of minimally invasive techniques for the treatment of shoulder pathology. Further developments in needle arthroscopy have continued this trend toward less invasive shoulder surgery, allowing for decreased pain using smaller portals and decreased fluid irrigation through the shoulder joint during surgery. This technique describes a minimally invasive rotator cuff repair using a dual-lumen cannula that provides both direct visualization and direct instrument access to the pathology. This new cannula has the potential to further refine and to simplify needle arthroscopic techniques about the shoulder. With judicious patient selection, needle arthroscopy is a viable option for the treatment of common shoulder pathology. Technique Video Video 1 A spinal needle is used to create a location for the standard lateral portal, and using a hemostat, the Passport Dual Lumen Cannula (Arthrex) is then inserted to be a working and viewing portal. A spinal needle is seen from superior, and lateral to the acromion, the placement for the medial 2 knotless anchors is located. A small stab incision is made and the punch is brought in, and while viewing from lateral, the medial anchors are placed. The medial swivel lock (Arthrex) anchors loaded with sutures are then placed in standard fashion. While viewing through the lateral portal with the NanoScope in the axillary lumen, a suture retriever is used to retrieve the suture tape coming out of the anterior-most anchor, and it is loaded into a Scorpion (Arthrex) suture passer. This passer is then used through the main lumen from the lateral portal to pass the anterior and posterior respective sutures through the rotator cuff. Those are then retrieved superiorly and cut to give 4 separate sutures. One anterior suture and 1 posterior suture are retrieved from lateral while still viewing with the NanoScope through the axillary lumen. These are placed through a knotless swivel lock, and the lateral row anchors are punched for from laterally in standard fashion. The anchors are then tensioned and placed into the bone while directly visualizing from the lateral portal. Final views of the repair and the shoulder are then seen.

Dataset Information

Excision of a Knee Cyclops Lesion Using a Needle Arthroscope.

Publications

Excision of a Knee Cyclops Lesion Using a Needle Arthroscope.

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