Intercondylar notch dimensions and graft failure after single- and double-bundle anterior cruciate ligament reconstruction.
OBJECTIVE
The objective of this study was to evaluate the dimensions of the femoral intercondylar notch intraoperatively and to determine whether a small intercondylar notch increases the risk of graft failure after individualized anatomic single- or double-bundle anterior cruciate ligament (ACL) reconstruction.


METHODS
A retrospective review of prospectively collected data was performed. One hundred and thirty-seven primary single- or double-bundle ACL reconstructions with at least 2-year follow-up were included in this study. Of these, 116 subjects had intraoperative notch measurements recorded. All operations were performed anatomically using a three-portal technique by the senior author. Intraoperative notch measurements (width at the base, middle, and top and height) were taken using a standard, commercially available arthroscopic ruler. Graft failure was defined as patient report of instability, pathologic laxity on clinical exam, or an MRI or arthroscopic diagnosis of rupture or absence of the ACL graft.


RESULTS
Graft failure at 2-year follow-up in the overall population was 13.9 % (19/137). Graft failure was reported to occur from contact or non-contact trauma, failure of the graft to incorporate, or hardware failure. The dimensions of the intercondylar notch and the graft type used did not influence the risk of graft failure.


CONCLUSIONS
Smaller intercondylar notch dimensions do not appear to be a risk factor for higher rates of graft failure after anatomic and individualized ACL reconstruction. Based on these data, the use of notchplasty is not supported in conjunction with individualized anatomic single- or double-bundle ACL reconstruction.
Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 1101, Pittsburgh, PA, 15213, USA.
Megan R
MR
Wolf
Christopher D
CD
Murawski
Floor M
FM
van Diek
Carola F
CF
van Eck
Yihe
Y
Huang
Freddie H
FH
Fu
D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy; D005260:Female; D005269:Femur / Q000033:anatomy & histology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D007718:Knee Injuries / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint / Q000033:anatomy & histology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D017847:Patellar Ligament / Q000637:transplantation; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D017211:Treatment Failure