Cyclops lesions develop in the anterior aspect of the intercondylar notch typically after anterior cruciate ligament (ACL) reconstruction or injury. National Library of Medicine MR Imaging of Knee Arthroplasty Implants. I'm just a bit pissed about this, as I was considering my 1st cycle. And I've stopped running for now. Chris Mallac, Physiotherapist is a highly qualified Physiotherapist and Educator. It is named accordingly due to its appearance, as during surgical removal of the lesion it looks like the eye of a cyclops. I'm about a year and a half post op with a hamstring graft, and I recently saw my surgeon about a lingering issue in my knee involving a sharp pain that feels like it's inside the kneecap. Examination under anaesthesia revealed positive Lachman and anterior drawer tests (both showing 510mm of anterior displacement of the tibia) as well as a positive pivot shift test. Sanders TL, Kremers HM, Bryan AJ, Kremers WK, Stuart MJ, Krych AJ. The cyclops lesion is a nodule of scar tissue that has grown in the front of the knee joint The cause of cyclops lesions is likely multi-factorial but may be linked to debris in the joint The hallmark sign of a cyclops lesion is loss of extension post-surgery Patients usually also have anterior knee pain and quadriceps dysfunction Arthroscopic treatment of patellar clunk. Our case differs from that of Rubin et al2 by the fact that it followed a four-strand hamstring reconstruction of the ACL. In one study, the incidence was 25% in the initial 6 months post-surgery, and 33% within two years. He works in private practice. Physical therapy is not an effective treatment for a cyclops lesion, other than for short-term symptom relief. doi:10.1148/rg.e26, Sonnery-Cottet, B., Lavoie, F., Ogassawara, R., Kasmaoui, H., Scussiato, R. G., Kidder, J. F., & Chambat, P. (2010). I have been going to pogo for 2 years now. Arthroscopic excision is the treatment of choice for cyclops syndrome. However it can be an issue for years post-op. The cyclops lesion after bicruciate-retaining total knee replacement. 10(5): p. 489-500, American Journal of Sports Medicine. An ACL reconstruction was performed ten weeks after the original injury. Your email address will not be published. The patient had a range of movement of 5130 post-operatively and at 2 months following excision of the lesion she had full active extension, flexion to 130 and a stable knee with negative Lachman, anterior drawer and pivot shift tests. . There a couple of competing theories on why the scar tissue develops. A pseudocyclops lesion (Figure 7) results from anteriorly displaced fibers from a partial tear of the ACL graft which can mimic a cyclops lesion clinically and on MRI.10. Splinting or bracing may be used for extension deficits. 8.2. Focal areas of fibrosis following TKA are often seen in the peripatellar region and can present with mechanical symptoms. We strip away the scientific jargon and deliver you easy-to-follow training exercises, nutrition tips, psychological strategies and recovery programmes and exercises in plain English. Journal of the American Academy of Orthopaedic Surgeon, 7(2), 119-127. The https:// ensures that you are connecting to the . Paulos LE, Rosenberg TD, Drawbert J, Manning J, Abbott P. Infrapatellar contracture syndrome. Developing collective mental resilience to manage competition demands, State of mind: understanding cognitive load in performance and injury rehabilitation. When cyclops lesions measured more than 10 mm . Results Cyclops lesions were found in 25% (28/113), 27% Sagittal fat-suppressed proton density-weighted (3A), sagittal T1-weighted (3B), and axial proton density-weighted images demonstrate a large heterogeneous cyclops lesion (arrows) anterior to the ACL graft. 174 NEWSNews and Provisional Program for 1951 Annual Meeting; Dis- trict Meetings; Technical Committee Notes. Loss of Extension After Reconstruction of the Anterior Cruciate Ligament. Patrick C. McCulloch MD. Muellner T, Kdolsky R, Groschmidt K, Schabus R, Kwasny O, Plenk H. Cyclops and cyclopoid formation after anterior cruciate ligament reconstruction: Clinical and histomorphological differences. Our international team of qualified experts (see above) spend hours poring over scores of technical journals and medical papers that even the most interested professionals don't have time to read. Keep up to date with the science and best practice in managing sports injuries. These exercises allow muscle recruitment without increasing the intra-articular pressure associated with full knee extension. Bone and Joint Clinic. the display of certain parts of an article in other eReaders. 1990. (2B) On the T1-weighted sagittal image, the nodular focus anterior to the ACL (arrow) is heterogeneous but almost isointense to the joint fluid and articular cartilage with subtle central areas of reduced signal. We are experimenting with display styles that make it easier to read articles in PMC. Sagittal proton density-weighted images demonstrate the normal appearance of the infrapatellar fat pad on the left and the typical mild post-surgical scarring following ACL reconstruction (arrowheads) on the right. Sometimes when patients undergo reconstruction surgery of their Anterior Cruciate Ligament (ACL) they have issues with achieving full extension (straightening) of the knee. 8. What are the findings? In general, a manipulation alone after acl reconstruction is not as successful. 2017 August ; 27(8): 34993508, Current Orthopaedic Practice. Resources. No cyclops lesion or scar tissue noticed. Magnetic resonance imaging (MRI) showed a complete rupture of the ACL with bone bruising of the lateral femoral condyle. He offers. Bethesda, MD 20894, Web Policies It is accepted that the origin is multifactorial.4 Cyclops syndrome has been reported following different types of grafts and procedures. Rubin et al reported the first case of an inverted cyclops lesion following a bone-patellar tendon-bone ACL reconstruction.2 They demonstrated a stalk for the cyclops lesion arising from the outlet of the femoral tunnel in pre-arthroscopy MRI. Another theory states that it may be fibrocartilage as a result of drilling the tibial tunnels. Why are total knees failing today? The only case reported previously was by Rubin et al following bone-patellar tendon-bone ACL reconstruction.2. Loss of full extension after anterior cruciate ligament (ACL) reconstruction, with development of an audible and palpable "clunk" with terminal extension was first described by Jackson and Schaefer as "cyclops syndrome." In: Doral M, Karlsson J, eds. This month, get insight and expertise on: Practical injury prevention advice, diagnostic tips, the latest treatment approaches, rehabilitation exercises, and recovery programmes to help your clients and your practice. It is a frequent complication associated with surgery and trauma. KOOS was also correlated with lesion volume. Evaluation and treatment of disorders of the infrapatellar fat pad. It may be more comfortable to have the weight applied either side of the knee joint if the knee itself is sore. An official website of the United States government. At the end of the procedure the patient had a range of movement of -5 to 140 and negative Lachman, anterior drawer and pivot shift tests. . doi: 10.1053/jars.2001.17997. What is your diagnosis? Select appropriate exercises, like quadriceps exercises performed in positions of partial (20) knee flexion or isometric squats in 20-30 flexion. Incidentally noted is a hemarthrosis (11B) (with joint fluid appearing hyperintense to muscle) associated with an intra-articular fracture of the posterior tibia (asterisk). The functionality is limited to basic scrolling. The origin was thought to be due to residues of bone and cartilage from drilling of the tunnels. 26(11), 1483-1488, J Orthop Res. Best answers. No loss for either but the pain & catching feeling when I fully extend it is what confuses me Like I try to straighten it and it gets to a point where theres pain but if I push through the pain (Its sharp but not unbearable) I can fully straighten it still, just as much as my other one. All the staff, from Michael the physio, Sato the massage therapist and Matt at reception were wonderful. The scar tissue can be made up of fibrous tissues, but can also include cartilage and sometimes bone. With this treatment, patients have a higher level of satisfaction, resolution of knee pain, return of physiological hyperextension (-5), optimal biomechanical joint movement and restoration of activity levels comparable to that following uncomplicated ACL reconstruction. Similar signal characteristics are noted at the posterior margin of the infrapatellar fat pad. We recommend a consultation with a medical professional such as James McCormack. Collateral ligaments, the posterior cruciate ligament and the posterolateral corner were intact. Often, due to the period of restricted mobility, the quadriceps muscles will not fire effectively and exercises are needed to regain normal function. "The procedure to repair a torn ACL is called a reconstruction, and the torn ligament is replaced with a tendon. So bad to the MRI it was. Unauthorized use of these marks is strictly prohibited. 11 months post-op here missing a few degrees of extension. i didn't have a cyclops lesion specifically, but i did have scar tissue buildup and needed an MUA & scoping 9 weeks post-op from the initial recon (hammy ACL graft + meniscal stitch). The development of patella baja is made more apparent by comparing current and prior studies by plain film or MRI (Figure 11). Many authors recommend arthroscopic debridement prior to manipulation under anesthesia to mitigate the risk of fracture, chondral damage, intra-articular hemorrhage, and ligament or tendon rupture. Bone debris from drilling during the ACLR. The American Journal of Sports Medicine, 29(5), 664675. A Cyclops lesion which is also known as localized anterior arthrofibrosis is defined as a painful lesion in the inner mass present at the anterior side of knee. Women have a higher risk, as the intracondylar notch is narrower. The incidence of cyclops syndrome in patients after ACL reconstruction ranges from 1.9 to 10.6%, whereas the incidence of cyclops lesions that do not cause extension loss ranges from 2.2 to 46.8% [ 4, 5, 6, 7, 8, 9, 10, 11 ]. Predicting Recurrent Patellar Instability in Paediatric/Adolescent Patients, Kienbocks Disease: Evidence Based Assessment and Management, TSP008: LARS/ACL Reconstruction with Jonathan Mulford, Thoracic Outlet Syndrome: Assessment and Management, The Benefit Of Electro-stimulation following ACL Reconstruction, Joint Line Fullness for Diagnosing Meniscal Pathology, Radial Tunnel Syndrome: Assessment and Management, Snapping Scapula Syndrome (Scapulothoracic Bursitis): Assessment and Management, Commonly symptomatic anterior knee pain with extension, Patients report issues with lying supine, walking and running, Sometimes patients report an audible clunk with extension, Loss of extension ROM (generally about 10 degrees): typically 2 3 months following reconstruction, Extension ROM sometime reproduces audible clunk, Quadriceps dysfunction, associated with extension deficit, Cyclops Lesion occur in about 4% of ACL reconstructions, Loss of extension ROM at 2 3 months following reconstruction is a hallmark sign, Symptoms also include extension related pain, swelling and quads dysfunction, Surgical management is indicated, as conservative physiotherapy management often fails, Outcomes of surgical debridement of cyclops lesions are good, Earlier: Eccentric Training for Flexibility, Earlier: Elite Tennis Physiotherapy with ATP Physiotherapist Paul Ness. That was back in December. Advanced exercises used in phase one and two of nonoperative treatment of youth ACL injuries. Identifying the difference between focal or referred posterior thigh pain is critical in developing the appropriate management strategy. It is not an actual Cyclops lesion as it is a torn ACL instead of fibrotic tissue. That is the groove of the femur when the ACL graft is fixed to. 22:10901096, Current Orthopaedic Practice. MRI of the right knee (Figure 3) showed a thickened patellar tendon, supra-patellar effusion, bone contusion and oedema in the anterior aspect of the tibial plateau as well as anterior and superior to the bony tract of the ACL repair. Never miss a podcast or blog post when you subscribe to our weekly newsletter. Epub 2016 Aug 3. To compare anterior cruciate ligament (ACL) soft-tissue allograft reconstruction using suspensory versus aperture fixation. Not only the best in the business in regards to diagnosing and treating injuries but have created and built up over time a very rare form of community and environment that makes you feel welcomed, valued and overall like you apart of something bigger than just getting treatment on an injury. The lesion forms at the anterior cruciate ligament insertion creating a painful extension block between femoral intercondylar notch and tibial plateau. TECHNIQUE STEPS. By continuing to browse this site you are agreeing to our use of cookies. The cyclops lesions had a mean size of 16 12 11 mm, with 90% of them located just anterior to the distal ACL. The tract of the transtibial pullout repair extends obliquely through the tibia (arrowheads). 2: 76-79, Arthroscopy: The Journal of Arthroscopic and Related Surgery. Large graft relative to intracondylar notch, slightly higher incidence with double bundle compared to single bundle for this reason. 1. Cyclops lesion after ACL Reconstruction When patients struggle to regain extension after ACL reconstruction, one of the important things to exclude is the 'cyclops' lesion. The Physical Performance Show: Dan Lorang Endurance Coach & Sports Scientist, The Physical Performance Show: Harry Garside Olympic Bronze Lightweight Boxing Medallist, The Physical Performance Show: 2022 TOP 10 Countdown, The Physical Performance Show: Dr Kevin Wernli Lower Back Pain: fear, posture, & movement, The Physical Performance Show: Dr Dan Plews Low CHO diet: Right Fuel-Right Time Approach, How Runners Can Overcome Tight Calves: My top 3 Exercises, Proximal Hamstring Tendinopathy Exercise Protocol, 13 Top Tips that will help your Proximal Hamstring Tendinopathy, The cyclops lesion is a nodule of scar tissue that has grown in the front of the knee joint, The cause of cyclops lesions is likely multi-factorial but may be linked to debris in the joint, The hallmark sign of a cyclops lesion is loss of extension post-surgery, Patients usually also have anterior knee pain and quadriceps dysfunction, Physiotherapy is ineffective once the lesion exists and arthroscopic surgery is needed which is often very successful, Its extremely important to work on regaining knee extension following any ACL surgery, Millett, P. J., Wickiewicz, T. L., & Warren, R. F. (2001). A cyclops lesion is a piece of scar tissue which develops on the anterior portion of an ACL. My surgeon still thinks it's scar tissue causing my issues. A band of low signal extends over the posterior aspect of the infrapatellar fat pad (short arrows). A 66 year-old female 10 years post ACL reconstruction with intermittent locking. Fig. Ann R Coll Surg Engl. It is a frequent complication associated with surgery and trauma. Disclaimer. Orthopedics. Complications following primary ACLR using quadriceps tendon autograft were recorded in 10.5% of knees, with persistent knee pain being most common. Complication of ACL repair. 2. From 2001 to 2006, the authors identified 10 patients (five women and five men, ages 27-76 years) with cyclops nodules seen at magnetic resonance (MR) imaging. This has all been terribly frustrating for me, so I'm sure it is for you too. Developmental hip dysplasia has the potential to derail the physical development of athletes at all levels. Fritz J, Lurie B, Potter HG. The goal of surgery is to prevent joint instability, which may further damage articular cartilage and menisci. Click on the banner to find out more. Arthrofibrosis is the abnormal proliferation of fibrous tissue in a joint leading to loss of motion, pain, muscle weakness, swelling, and functional limitation and is most commonly associated with joint trauma or surgery.1. Great bang for your buck in terms of quality and content. The cause of arthrofibrosis is multifactorial and incompletely understood. It may be an incidental finding on a follow-up scan or if the knee is scanned for another reason. Lock & unlock your knee, not letting it flick or flop back to straight. ACL in tact." Arthroscopy: The Journal of Arthroscopic & Related Surgery, 8(1), 10-18. doi:10.1016/0749-8063(92)90129-y, Minne, C., Velleman, & Sulleman, F. E. (2012). Podcast. In fact, autograft tissue (tissue from one's own patellar tendon or hamstring tendon) is stronger than the ACL. If you have decided that surgery is the best option, we take a look at the options for reconstruction and assess the pros and cons. MRI is effective as a tool to evaluate unexplained pain, limited range of motion, and functional limitation in the postoperative patient in whom arthrofibrosis is suspected. I was reading about them on Google and some of the symptoms line up like the quad not fully coming back, audible clunking or occasional catching like I said when I try to fully extend it sometimes, but I have no loss of extension and can straighten both legs the same. The reconstruction was performed using a four-strand hamstring graft and fixed on the femoral side using the TransFix technique and Bio-Interference screw (Arthrex, Naples, FL, US) fixation for the tibial side. It is believed to be a remnant of the previous ACL stump that had remained during the reconstruction surgery. MRI can confirm and define the extent of a suspected fibrotic lesion and assist in detecting and differentiating other postoperative complications with a similar clinical presentation. Its also been suggested that the cyclops lesion was caused from graft impingement when the knee was in full extension which leads to scar tissue formation (4). Before reconstruction of her ACL 10 weeks after injury, she had full range of movement and findings for instability included positive Lachman and anterior drawer tests (both showing 05mm of anterior displacement of the tibia) and a negative pivot shift test. Forums. I have seen Brad twice now and he is absolutely fantastic. A cyclops lesion is a complication from anterior cruciate ligament reconstruction (ACLR) surgery. I couldn't recommend the practise more :-). Adhesions in the suprapatellar bursa can form between the capsular elements of the bursa and the medial or lateral gutters. Abreu MR, Chung CB, Trudell D, Resnick D. Hoffas fat pad injuries and their relationship with anterior cruciate ligament tears: New observations based on MR imaging in patients and MR imaging and anatomic correlation in cadavers. MR Imaging of Cyclops Lesions. Regaining full knee extension is one of the most important goals to achieve as soon as possible after ACLR surgery. In general, arthroscopic debridement is preferred to open debridement when the pathology is largely intra-articular. Following because this matches all of my issues to a T. I'm also a year and a half out, though I had a quad graft, and had a second surgery for more meniscus issues, bone spurs and cartilage blistering issues. Clipboard, Search History, and several other advanced features are temporarily unavailable. Sonographic and Magnetic Resonance Imaging Examination of a Cyclops Lesion After Anterior Cruciate Ligament Reconstruction: A Case Report. A 60 year-old male 4 years post TKA complains of pain and popping of the knee with walking for the last 6 weeks. Retrieved from http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S1681-150X2012000200011. Knee postoperative stiffness manifests as an insufficient range of motion, which can be caused by poor graft position, cyclops lesions, and arthrofibrosis [5,6,7]. RadioGraphics, 27(6), e26-e26. In simple terms, it is a lump of scar tissue at the front of the knee and it blocks it from completely straightening. 2020 Jul;49(Suppl 1):1-33. doi: 10.1007/s00256-020-03465-1. Methods After we performed prospective power analysis and obtained institutional review board approval, as well as patient consent, 64 patients were block randomized among 3 study sites to the aperture fixation group or . A cyclops lesion is described as a focal anterior arthrofibrosis, which is an excessive formation of scar tissue on the anterior cruciate ligament. We recommend a consultation with a medical professional such as James McCormack. This is part of the screw-home mechanism or that locked out feeling you get when you straighten your knee. No stones are left unturned in their pursuit for their patients physical best. 8600 Rockville Pike All patients had a history of trauma but no history of ACL reconstruction. Scarring and contraction resulting in a foreshortened suprapatellar bursa leads to further loss of knee flexion.2, Fibrosis of the infrapatellar fat pad appears to be an important cause of pain and stiffness.12,13 The infrapatellar fat pad is susceptible to trauma at the time of the ACL tear, from untreated instability, and from subsequent arthroscopic surgery and ACL reconstruction. Apr 11, 2013. Assessment of the type of deficit is important in directing the therapeutic approach. Evaluate the TCO of your PACS download >, 750 Old Hickory Blvd, Suite 1-260Brentwood, TN 37027, Focus on Musculoskeletal and Neurological MRI, September 2008 Web Clinic Patellar Fat Pad Abnormalities, The Anterior Meniscofemoral Ligament of the Medial Meniscus. An often overlooked code is 29884 Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure), which may be assigned for excision of fibrosis/adhesions/scar due to previous procedures or injuries. 70-B(4): p. 635- 638, Journal of Athletic Training, 2010. The appearance and clinical history are suggestive of patellar clunk syndrome. The cyclops lesion, also known as localized anterior arthrofibrosis, is a painful anterior knee mass that arises as a complication of anterior cruciate ligament (ACL) reconstruction, although has rarely been reported in patients with ACL injuries that have not been reconstructed. Initially, a more aggressive physical therapy regimen is attempted along with anti-inflammatory medications. Previous studies reported that after ACL reconstruction, the incidence of joint stiffness was between 4 and 38% [8]. MRI findings of cyclops lesions of the knee. Gandhi R, De Beer J, Leone J, Petruccelli D, Winemaker M, Adili A. Predictive risk factors for stiff knees in total knee arthroplasty. Also, moving your knee in & out of terminal extension helps develops hamstring and quadriceps control which can be lacking post-injury. Clinical Outcomes After Arthroscopic Release of Patellofemoral Arthrofibrosis in Patients With Prior Anterior Cruciate Ligament Reconstruction. A Biblioteca Virtual em Sade uma colecao de fontes de informacao cientfica e tcnica em sade organizada e armazenada em formato eletrnico nos pases da Regio Latino-Americana e do Caribe, acessveis de forma universal na Internet de modo compatvel com as bases internacionais. It can block the knee range of movement, limiting the full extension of the knee, and can therefore cause quadriceps dysfunction. Activation and strengthening of your quadriceps muscles will provide you will more power to extend your knee and keep it straight with functional tasks like standing and walking. You may switch to Article in classic view. It is not a huge loss of extension, often less than 10, but its enough to be a problem (8). Subjects with cyclops lesions did not have an inferior clinical outcome. Cyclops lesions can be found in up to 25% of ACL reconstructions at 6 months after surgery. MRI of the right knee ( Figure 3) showed a thickened patellar tendon, supra-patellar effusion, bone contusion and oedema in the anterior aspect of the tibial plateau as well as anterior and superior to the bony tract of the ACL repair. The exact aetiology is uncertain. The risk of cyclops lesions is between 1-10% of ACLR surgeries. You are viewing 1 of your 2 free articles. Limitation of extension is one of the complications after anterior cruciate ligament (ACL) reconstruction commonly caused by a cyclops lesion, which is most frequently seen in the anterior aspect of the knee arising near the tibial attachment of the graft. B. Rehabilitation of soleus muscle injuries in distance runners, Uncommon injuries: sural nerve neuropathy, Dr. Alexandra Fandetti-Robin, Back & Body Chiropractic, Hamstring or not? Press question mark to learn the rest of the keyboard shortcuts. MR Imaging of Cyclops Lesions. Typically a cyclops lesion will occur in the months or years after ACLR surgery, with a greater risk of incidence with greater time since surgery. Steadman JR, Dragoo JL, Hines SL, Briggs KK. Would you like email updates of new search results? Debridement of cyclops lesions after total knee replacement (s) is a . Other factors that can lead to knee stiffness and restriction in motion after ACL reconstruction may also play a role in the development of arthrofibrotic lesions and include suboptimal femoral or tibial tunnel placement and an overtensioned ACL graft.2, The cyclops lesion, a well-known complication of ACL reconstruction surgery, is an ovoid fibroproliferative nodule found anterior to the ACL graft. and transmitted securely. 12. Early pool work also provides hydrostatic pressure to aid with effusion drainage. We use cookies so we can provide you with the best online experience. The cyclops lesions had a mean size of 16 x 12 x 11 mm, with 90% of them located just anterior to the distal ACL. Usually the patient will also have some quadriceps dysfunction. Glossary of terms for musculoskeletal radiology. The development of cyclops lesions is a multi-factorial process and hard to predict (3). 35(8): 1269-1275. The repaired ACL was intact. ACL Brace, This is not medical advice. A Cyclops lesion is a complication following an ACL injury which occurs in about 5% of cases. It was first described in patients with ACL reconstruction [1] but recently it has been reported cases without this antecedent [2]. Or sometimes if I'm lying down with my knees bent, then try to raise my leg and fully straighten it or if I'm just sitting and try to straighten it, there's a sharp pain and sometimes it'll hurt but then my kneecap will pop and I can straighten it with no pain. 3, Quarterly Journal of Experimental Physiology, 1988. Unable to load your collection due to an error, Unable to load your delegates due to an error. A focus of soft tissue thickening is compatible with a small cyclops lesion anterior to the graft (arrowhead). FOIA I also expla. Injury after AC. Log in Register. One case has been reported previously following a bone-tendon-bone reconstruction of the ACL but a similar case has not been reported. Conventional methods include elevation, compression with donut felt, effusion massage, and limited weight-bearing. Sagittal T2-weighted (5A) and axial fat-suppressed proton density-weighted (5B) images demonstrate a 5 mm intra-articular chondral body (arrows) surrounded by joint fluid anterior to the ACL graft. Knee postoperative stiffness manifests as an insufficient range of motion, which can be caused by poor graft position, cyclops lesions, and arthrofibrosis [5,6,7]. I love the work the SIB team is doing and am always looking forward to the next issue. Adhesions can form between the capsule and articular cartilage. Despite such prevalence, cyclops lesions generally have minimal or no clinical symptoms, and their presence does not portend an inferior clinical outcome, with only 2% of cyclops lesions prompting surgical intervention.9 Symptomatic lesions present with loss of extension, snapping, catching, and painful extension with walking and/or running resulting in the cyclops syndrome. 7,8, MRI can assist in distinguishing cyclops lesions from other pathology that may limit knee extension, including roof impingement of the ACL graft (Figure 5), intra-articular bodies (Figure 6), and displaced torn ACL graft fibers. look for a Cyclops lesion, because it's in five to 10% of cases typically, but I think it's underdiagnosed and it's a reason why people . eCollection 2019 Dec. Arthroplast Today. They proposed that this debris caused formation of the granulation tissue. So I guess my question is, for those of you who have had a cyclops lesion, does this sound like one or what you went through?