Cyclops Lesion Surgery, Recovery, Recurrence, ACL, This website is an online medical resource dedicated to offering detailed and current literature on diseases, remedies, health care, drugs and medical conditions. It is believed to be a remnant of the previous ACL stump that had remained during the reconstruction surgery. bunch of grapes sign (botryoid rhabdomyosarcoma), bunch of grapes sign (intracranial tuberculoma), bunch of grapes sign (intraosseous hemangiomas), bunch of grapes sign (multicystic dysplastic kidney). ADVERTISEMENT: Supporters see fewer/no ads. Inverted Cyclops Lesion without Extension Block: A Case Report and Literature Review. Don't let scams get away with fraud. At least thats one theory. he had ACL, MCL meniscus repair 10 months ago and the pain hasnt let him play fully sports. Lets dive deeper into this! I feel better now than before the surgery. If you do not want that we track your visit to our site you can disable tracking in your browser here: We also use different external services like Google Webfonts, Google Maps, and external Video providers. Sonnery-Cottet et al. Available from: van Dijck RA, Saris DB, Willems JW, Fievez AW. Use crutches as needed for the first couple of days. Localized anterior arthrofibrosis, also called the cyclops lesion, is the second most common cause of extension loss after ACL reconstruction, with a frequency of 1-9.8%, the most common being graft impingement, which develops due to anterior placement of the tibial tunnel. Use crutches as needed for the first couple of days. time of surgery, recovery time, pain control and postoperative function [4-7]. Attach a band to something stationary. For those not familiar, a cyclops lesion is a wad of scar tissue in the anterior aspect of the knee joint. It's so much easier compared to ACL recon, especially if you've already done a lot of rehab. . Gaining and maintaining full left knee extension will be crucial to prevent scar tissue forming within the knee joint (called a "cyclops lesion"), which would require surgery to remove . 1. the invisible life of addie larue special edition. Symptoms of Anterior Crucament Ligament Injury. Cyclops syndrome is a cyclops lesion that causes a loss of terminal extension. Surgery, And ACL Recovery Time 8 Lifestyle Steps You Should Take To Heal Your ACL Tear Injury Rehabilitation Exercises For ACL Tear Injury 4 Rehab Exercises . This would require surgery but I think that would be a good thing for you and give you much relief within a few weeks. Im almost 7 months ACL post-op. Serial MRI and clinical assessment of cyclops lesions. AD, MRI examination showing cyclops lesion. Cyclops procedure? Noailles T, Chalopin A, Boissard M, Lopes R, Bouguennec N, Hardy A. Orthop Traumatol Surg Res. Report at a scam and speak to a recovery consultant for free. typically a cyclops lesion will block the range of motion, especially extension. Arthroscopy 1998 Nov-Dec; 14 (8) 869-876. Epub 2019 Aug 9. 1173185, Mechanism of Injury / Pathological Process. Radiopaedia.org; 2021. Unable to load your collection due to an error, Unable to load your delegates due to an error. 4. Our Experience with Cyclops Lesions That Occur after ACL Injury without Reconstruction. We as patients must advocate for themselves and ask their surgeons about their complication rates. Published by Elsevier Ltd.. All rights reserved. Im 3 months 2 weeks post op (BTB Patellar Tendon ACLR). Please advise. It is not recommended to remove asymptomatic lesions[2]. Worsening pain in the knee. Other factors to consider include: These are tell-tale signs that theres more going on and you should refer back to the doctor so they can order an MRI to rule in/out the anterior scarring. Push your knee back against the band to straighten your leg as much as possible. I had an ACL replacement + meniscus repair done in 1 surgery. Chris Cooper, Accountant), Finch House, 28/30 Wolverhampton Street, Dudley, West Midlands, DY1 1DB, United Kingdom. This technique we published focuses on fatiguing the hamstring tendons after surgery so that they relax and allow us to obtain a fully straight knee. The 'cyclops' lesion that we refer to in the knee is a fibrous nodule, resembling an eyeball, localised to the middle of the rounded part of the femur, and obscuring the notch area and cruciate ligaments. These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience. Epidemiology Khambhampati et al report 8 risk factors for cyclops lesions:[2]. It usually occurs 2-3 months after the surgery however it is possible to occur after years of surgery depending on different individual. doi: 10.1016/j.eats.2021.12.008. 2022 Mar 16;11(4):e563-e568. If surgery is necessary, the physical therapy helps ensure a better result and a faster recovery. It also prevents excessive tibial medial and lateral rotation, as well as varus and valgus stresses. Between 2001 and 2007, we identified 10 patients with cyclops lesions without ACL reconstruction. Good luck. -, Balcarek P, Sawallich T, Losch A, Strmer KM, Frosch K-HH. Hamstring Contracture After ACL Reconstruction Is Associated With an Increased Risk of Cyclops Syndrome. 13 If the knee appears irritated more than 4 weeks . Clinical and operative characteristics of cyclops syndrome after double-bundle anterior cruciate ligament reconstruction. Increasing pain may be a sign of arthrofibrosis. A person may be able to. The site is secure. official website and that any information you provide is encrypted Lesion signal is usually heterogeneous and there is variable contrast enhancement. Home richfield school district cyclops lesion knee surgery recovery time. jordan devlin finisher; memphis colby instagram; fr mike schmitz bible in a year reading plan; mcg general admission seating map; homes for sale by owner in cocke county, tn; tara lipinski sister; cyclops lesion debridement cpt Blog Filters. You are free to opt out any time or opt in for other cookies to get a better experience. Did the doctor do an MRI? I would do it again because the lesion was really messing me up, but it was difficult and I will still probably never have 100% ROM. Gaillard F. Cyclops lesion (knee): Radiology reference article. Online ahead of print. Your email address will not be published. Kambhampati S.B.S., Gollamudi S., Shanmugasundaram S., Josyula V.V.S. A recent study showed that just a simple loss of 3 to 5 of knee extension resulted in worse outcomes and satisfaction after surgery. Abnormal tissue growth and scar formation in the postoperative knee can create a block to terminal extension of the knee. In some cases the studies have shown that, chances of its prevalence increases as time passes post anterior cruciate ligament reconstruction (ACLR) with the incidence being reported 25% up to first 6 month of ACLR to 33% at 1 year after ACLR, and further to 46.8% after a year of ACLR. Healthy articular cartilage is a central component of a normal healthy joint. My daughter is nearly 16 months out from her ACL reconstruction, and then 5 months ago required a surgery for a Cyclops Lesion to be removed. Conclusions: Cyclops lesions should be suspected after arthroscopic intra-articular knee surgery when the patient has difficulty regaining extension concurrent with a sensation of. This site uses cookies. These lesions can also develop in knees that have had ACL injury without a reconstruction (3). Sign up to stay in touch. -, Delcogliano A, Franzese S, Branca A, Magi M, Fabbriciani C. Light and scan electron microscopic analysis of cyclops syndrome: etiopathogenic hypothesis and technical solutions. Misdiagnosis of an atypical cyclops lesion 4 years after single-bundle anterior cruciate ligament reconstruction. Bull Hosp Jt Dis (2013). Note that blocking some types of cookies may impact your experience on our websites and the services we are able to offer. Hi Jordyn, sorry to hear about your injury. Pfirrmann. Your email address will not be published. -. that surgery was so, so much easier than the first and eliminated a ton of my pain related to the scar tissue and limited mobility. by in enns military base 1940 best acl surgeon uk in enns military base 1940 best acl surgeon uk Each had participated in an aggressive rehabilitation program for a minimum of 2 months with emphasis on regaining full range of knee motion. 2020 Aug 28;8(8 . You can check these in your browser security settings. We need 2 cookies to store this setting. Click to enable/disable Google Analytics tracking. National Library of Medicine At this point, you should have full ROM. I would leave that up to his PT or ATC but may be a bit quick, in my opinion. Cyclops lesions can be associated with anterior interval lesions. The distinctive and common sign of the presence of cyclops lesion is inability to extend the knee fully and unresolving swelling following an ACL reconstruction surgery. At least that's one theory. Cyclops lesions were examined carefully and with the use of electron microscopy they were discovered to contain the following constituents: dense fibroconnective tissue rich in newly formed blood vessels, variable amounts of cartilage, bony tissue and occasionally some apparently dead bone. 2022. In my experience, you will need surgery but it is a lot less involved and painful than the ACL surgery. Pathologically, the lesion consists of central granulation tissue lined by synovium and surrounded by dense fibrous tissue. The literature, seems to place the responsibility squarely on the surgeons shoulders. I was on crutches and unable to bend my knee longer than I expected but in the end, it was worth it. A cyclops lesion with loss of knee extension with or without an audible or palpable cluck at terminal knee extension constitutes the cyclops syndrome. In fact, autograft tissue (tissue from one's own patellar tendon or hamstring tendon) is stronger than the ACL. I can walk on it but it hurts when I do. On every re-occurrence of Cyclops lesion, surgery is necessary. It is just a scope surgery and you should start PT the very next day. 1996;4(4):194199. 2019 Nov;105(7):1401-1405. doi: 10.1016/j.otsr.2019.07.007. The cyclops lesion that we refer to in the knee is a fibrous nodule, resembling an eyeball, localised to the middle of the rounded part of the femur, and obscuring the notch area and cruciate ligaments. . This systematic literature review helped to identify . . Careers. Crunching and cracking (pain free, hopefully) in the knee is very normal after an ACL. In fact, autograft tissue (tissue from one's own patellar tendon or hamstring tendon) is stronger than the ACL. I had my MRI done last week and it didnt show any evidence of Cylops Lesion but the my doctor thinks that it is Cyclops Lesion and said that he has to go inside my knee to trim it off. Sites of occurrence of cyclops lesion and its variants: classic cyclops lesion at, MeSH Good luck! Also with the Cyclops Lesion does the knee get weaker as time passes? But this will always prompt you to accept/refuse cookies when revisiting our site. Good luck! Click on the different category headings to find out more. I am just confused now. Hold for a few seconds and slowly release. Knee Surg Sports Traumatol Arthrosc. The impact on our quality of lives, the need to change careers, is certainly worth the surgeon taking an extra 45 minutes in the operating room to make sure he or she has addressed all aspects of the surgery within his or her control to guarantee an exceptional outcome., I was curious to know whether a particular graft was associated with a higher rate of Cyclops lesion as compared to others. Cyclops lesion is a known complication of anterior cruciate ligament reconstruction (ACLR). Nintendo Wii Balance Boards. Home Uncategorized cyclops lesion knee surgery recovery time. cyclops lesion knee surgery recovery time. Regain strength in the knee as well as the thigh and shin muscles. You may have a history of being able to over straighten the knee, called knee hyperextension or genu recurvatum. Because these cookies are strictly necessary to deliver the website, refusing them will have impact how our site functions. How long does it take to get full extension after cyclops removal and what is a typical recovery time? bellerive country club / append array pseudocode / cyclops lesion rehab protocol. Previous studies reported that after ACL reconstruction, the incidence of joint stiffness was between 4 and 38% [8]. J. Don't let scams get away with fraud. (2020) Skeletal Radiology. FBiH - Konkursi za turistike vodie i voditelje putnike agencije. Youre only 3+ months post-surgery so theres still a lot more strength to be gained over the next 6+ months. Discomfort when walking. Previous studies reported that after ACL reconstruction, the incidence of joint stiffness was between 4 and 38% [8]. Cyclops lesions are an unfortunate sequelae of anterior cruciate ligament injury, and are most commonly seen following ACL reconstructions. Sport is his life. J. Orthop. Registered Address: The KNEEguru, c/o Price Pearson Limited (att. Epub 2022 Oct 18. can a cyclops lesion grow back. A, Arthroscopic image showing synovitis of the knee; B, cyclops lesion at the intercondylar notch; C, well surrounded cyclops with synovitis; D, granulation tissue once cyclops is opened; E, frontal view of cyclops lesion; F, intact ACL after cyclops excision; G, intact medial meniscus with chondral frame. 6 months later and despite the continuous PT i cant have hyperextension of my knee and i feel its locked at certain range of extension. If interested, check it out atwww.onlinekneeseminar.comand let me know what you think. If youre good enough then colleges will def consider you. The camera shows images of the inside of your knee, which helps your healthcare provider make a diagnosis of your injury. Debridement of cyclops lesions after total knee replacement (s) is a . Why is my knee so tight after ACL surgery? After surgery, the patient should be able to bear weight on the knee when standing or walking. Kambhampati SBS, Gollamudi S, Shanmugasundaram S, Josyula VVS. I have an appointment with my surgeon approaching to get an MRI, but I was wondering if you thought this may be a cyclops lesion? 1 Bolverkk 4 yr. ago Thank you for the response! Good luck! In this video, I describe why and how I assess for a cyclops lesion. Second-look arthroscopic findings of 208 patients after ACL reconstruction. My site, Lennymacrina.com is a place where rehab professionals can come to help simplify their approach to client care, just as I have since I started practicing PT in January 2003. a cyclops lesion, or an interiorly placed ACL graft [1]. FOIA Cyclops lesion in the anterior knee blocking full (hyper) extension. Possible problems that can lead to the re-tear of the ACL include suboptimal positioning of the graft, improper tension on the graft, or failure of the fixation of the graft. Sports Med. J. Introduction [edit | edit source]. Cyclops lesions occur with an estimated frequency of ~5% (range 1-9.8%) of patients following ACL reconstruction. Ask what the rates of revisiting the operating room are. PMC Check to enable permanent hiding of message bar and refuse all cookies if you do not opt in. J Knee Surg. 27 (6): e26. xander bold and beautiful dies. ACL grafts are very strong. Patients are encouraged to contact Dr. Getelman if they experience loss of motion that does not recover with PT determine if cyclops lesions are present. graft (. Treatment requires arthroscopic excision of the lesion and aggressive rehabilitation. anterior knee pain after increasing activity, assess/measure each visit to determine gains or losses, get the pain and swelling out as quickly as possible, refer back to the doctor if the ROM not improving despite your best efforts. Without doing an exam on you, it sounds like you may have some form of general scarring in there and I wouldnt be surprised if you had a cyclops lesion. Is it something that can reappear again with time? I had to have a manipulation under anesthesia after the surgery, to help my knee get more flexibility. Impingement of the graft in knee extension is also postulated 4. Although the lesions (a lesion means an abnormality) are almost always often found in this anterior location, they have been located laterally after a lateral meniscectomy procedure, but in this instance they do not interfere with extension. 2020;8(8) 2325967120945671. Unable to process the form. Cyclops Lesions of the Knee: A Narrative Review of the Literature. It is important to distinguish between cyclops lesion and cyclops syndrome, as management differs based on symptoms. Patients typically have good prognosis of recovering function and full knee range of motion following excision surgery[8]. Though the median time for arthroscopic intervention is 16 weeks, cyclops lesions have been excised as long as 24 years from the initial trauma. I noticed online everyone is saying they need surgery to make this go away. The cause of cyclops lesions is likely multi-factorial but may be linked to debris in the joint. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). This site needs JavaScript to work properly. Click to enable/disable _gid - Google Analytics Cookie. 2. Meniscal maceration is a finding sometimes used on MRI imaging to describe wasting away of the meniscus or cause to become soft or separated into constituent elements. 2019 Nov;105(7):1401-1405. https://radiopaedia.org/articles/cyclops-lesion-knee?lang=us, https://www.pogophysio.com.au/blog/acl-surgery-cyclops-lesions/#:~:text=Unfortunately%2C%20physiotherapy%20isn't%20able,to%20regain%20extension%20(2), https://www.physio-pedia.com/index.php?title=Cyclops_Lesion_(Knee)&oldid=293172, Female sex due to narrow intercondylar notch, Increased volume of graft in relation to the notch size, Double-bundle ACL reconstruction due to higher volume of graft, Bicruciate-retaining arthroplasty because of ACL injury or sharp tibial bone island, Rubbery end-feel to extension with a palpable pop, Grinding with attempted extension beyond patient's limit, Gouty tophus can cause loss of knee extension and cyclops-like appearance due to build up of gouty deposits, Localized intraarticular giant cell tumor of the tendon sheath. Anyway, I had my surgery done about two weeks later in the Jan of 2009. the foundation underlying feminist therapy asserts that: can a cyclops lesion grow back. Radiology. Rehabilitation Of Torn ACL After Surgery. The incidence of symptomatic cyclops lesion ranged from 1.9% to 10.9%. Physical therapy can only be targeted towards symptomatic relief and no matter how much a physiotherapist tries, full knee extension cannot be achieved until a second arthroscopy is carried out to remove the nodule/ scar tissue. eCollection 2022 Apr. At the time the article was created Frank Gaillard had no recorded disclosures. Clinically it is reported to have prevalence of 1% to 10% but magnetic resonance imaging (MRI) studies have shown the physiological changes occurring in about 25% to 47% of cyclops lesions. cyclops lesion knee surgery recovery timewhat does the bible say about emotional walls. your symptoms sound typical of a cyclops lesion but because youve had it for so long it may be difficult to regain your mobility as quickly as normal. #2. limpieza de huevo paso a paso; blockbuster store still open near haarlem; marvin integrity windows; sarah danielle goldberg cause . I could not find any literature to indicate that any one type of graft was immune. Cyclops is a fibrous nodule on the tibial side of the knee and it is one of the common complications that arises after anterior cruciate ligament (ACL) reconstruction surgery that causes loss of knee extension. National Library of Medicine 2010 Nov;26(11):1483-8. William Palmer, Laura Bancroft, Fiona Bonar, Jung-Ah Choi, Anne Cotten, James F. Griffith, Philip Robinson, Christian W.A. Information provided on the site is meant to complement and not replace any advice or information from a health professional. The management of choice for symptomatic lesions is surgical excision. 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]. 2000;174(3):719726. Mccauley TR. Giu 11, 2022 | how to calculate calories per serving in a recipe. Hi Gina, seems like most take at least a month to recover but often longer to really feel normal and get their motion back and full strength. You always can block or delete cookies by changing your browser settings and force blocking all cookies on this website. Trending posts and videos related to Medial Meniscus Tear Surgery! Required fields are marked *. 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. At least that's one theory. I have full mobility but my knee is very crunchy (usually in the mornings) and cracks sometimes, most the time it isnt followed by pain, but sometimes there is a sharp pain. This results in the formation of a nodule of fibrous tissue in the anterior portion of the ACL graft (Tonin et al., 2001). Report at a scam and speak to a recovery consultant for free. unique traits of plants, animals and humans. I cant full extend my knee (3-6 deg.) Clitoromegaly - Pictures, Size, Symptoms, Causes, Treatment, Lymphocele on Penile shaft & groin Pictures, Treatment, Diagnosis, What is Ptyalism - Definiton, Symptoms, Causes, Treatment, What is Skeeter syndrome - Definition, Symptoms, Causes, Treatment, Hypopyon - Definition, Symptoms, Causes, Treatment, What is Hyposmia - Definition, Symptoms, Causes, Treatment, Hyperfixation - Meaning, Definition, Anxiety/Depression. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). For symptomatic cyclops lesions, arthroscopic surgical debridement of the lesion can restore normal biomechanics of the knee[2]. Loss of mobility and range of motion. 1. 2022 Nov 9. doi: 10.1007/s00167-022-07219-5. As with other internal derangements of the knee, MRI is the modality of choice for assessing the postoperative knee. She continued her strength and conditioning and played her first game last night - today there is swelling and pain.is this normal? Bookshelf Selective bundle versus complete anterior-cruciate ligament reconstruction: A systematic review and meta-analysis. Active rehabilitation via physical therapy is required to help the knee to heal and to: Reduce pain and swelling. Kambhampati SBS, Gollamudi S, Shanmugasundaram S, Josyula VVS. bellerive country club / append array pseudocode / cyclops lesion rehab protocol. Ive never been able to bend it very far only a little more than 90 degrees and it hurts the inside of my knee. Following surgical ACL repair, a patient will be placed in a brace and instructed to use crutches for a brief period of time. as the blog post mentions, pain in the front of the knee with full knee extension and the inability to achieve full extension ROM even after working on it for several PT sessions. Had an MRI two weeks ago and diagnosed a 1.4cm cyclops lesion. 1999;7:284289. 2. ago. Seen as an ovoid-shaped mass with venous vessels in the center (1), these lesions are usually found in the femur's intercondylar notch (4,5). 13 If the knee appears irritated more than 4 weeks after ACLR, the likelihood of arthrofibrosis, a significant proportion of which is due to cyclops lesion, 22 should be considered. The cyclops lesion is a fibrous nodule with central granulation tissue located anterolateral to the tibial tunnel after intra-articular reconstruction of the anterior cruciate ligament (ACL) that . I did all of my physical therapy and exercises at home. Surgeons Jackson and Schaefer (1990) dramatically reduced the incidence of cyclops lesions in their operative ACL patients by following some basic tenets: Perhaps the most convincing evidence that the cyclops lesion is distinct from arthrofibrosis lies in its composition. Probably a scenario that will play out over the next few weeks but need to get symmetrical knee extension in order for her to feel her best long term. Glossary of terms for musculoskeletal radiology. MR imaging of cyclops lesions. Click to enable/disable Google reCaptcha. Doing so will decrease the risk of re-injuring your knee and re-tearing your ACL. Clinically it is reported to have prevalence of 1% to 10 % but magnetic resonance imaging (MRI) studies have shown the physiological changes occurring in about 25% to 47% of cyclops lesions. ACL grafts are very strong. associated with age < 20 years and graft size < 8mm. land for sale in highgate, st mary jamaica . The moniker of "cyclops lesion" was given based on the arthroscopic appearance of the fibrous nodule and vessels that resemble an eye. Within 1-2 weeks, you should be able to regain full range of motion. Check out this MRI that shows the scar tissue in the anterior knee. Orthop Traumatol Surg Res. Use ice readily over the first few days, and start e. 2017 Jan 27;5(1):2325967116684121. doi: 10.1177/2325967116684121. Would you like email updates of new search results? Hi, I had a total knee replacement 12/11/13. July 3, 2022 July 3, 2022. There are many things that could affect a patients outcome. The .gov means its official. HHS Vulnerability Disclosure, Help how to sell burial plots in maryland / puraqua sparkling frost flavors / can a cyclops lesion grow back. The timing of recovery from knee surgery depends on the type of procedure and factors such as the person's age, overall health, and circumstances such as occupation. xander bold and beautiful dies. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-1187, View Frank Gaillard's current disclosures, see full revision history and disclosures, anterior cruciate ligament (ACL) reconstruction, bucket handle appearance (disambiguation), bucket handle fracture - non-accidental injury, cockade sign (aorto-left ventricular tunnel), cockade sign (hypertrophic pyloric stenosis), corkscrew sign (diffuse esophageal spasm), hockey stick sign (Creutzfeldt-Jakob disease), light bulb sign (posterior shoulder dislocation), stepladder sign (intracapsular breast implant rupture), stepladder sign (small bowel obstruction), eccentric target sign (cerebral toxoplasmosis), trident sign (persistent primitive trigeminal artery), ginkgo leaf sign (subcutaneous emphysema), chronic inflammatory demyelinating polyneuropathies, salt and pepper sign (vertebral hemangioma), teardrop sign (inferior orbital wall fracture), teardrop sign (intracapsular breast implant rupture), snake-eye appearance (cervical spinal cord), butterfly shape of the grey matter of the spinal cord, caput medusae sign (developmental venous anomaly), doughnut sign (missed testicular torsion), ice cream cone sign (middle ear ossicles), ice cream cone sign (vestibular schwannoma), in total anomalous pulmonary venous return, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity. An official website of the United States government. Rede Performance de Ensino > Sem categoria > can a cyclops lesion grow back . It is considered a main complication of anterior cruciate ligament ACL reconstruction. Before Other studies have suggested that having a delayed period of time between surgery and achieving full extension of the knee can lead to the develop of a cyclops lesion. Knee Surg Sports Traumatol Arthrosc. Are you lacking knee extension? I had an ACL reconstruction surgery almost 3 years ago and since suffered with a stiff knee and loss of extension. 4. It is clear that the drilling debris from an ACL reconstruction plays a major role in the formation of these lesions.

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