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Femoral intercondylar notch shape and dimensions in ACL-injured patients

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The femoral intercondylar notch has been an anatomic site of interest as it houses the anterior cruciate ligament (ACL). The objective of this study was to arthroscopically evaluate the femoral notch in patients with known ACL injury. This evaluation included establishing a classification for notch shapes, identifying the shape frequency, measuring notch dimensions, and determining correlation between notch shape, notch dimensions, and demographic patient data. In this clinical cohort study, 102 consecutive patients underwent diagnostic arthroscopic evaluation of the notch. Several intra-operative photos, videos, and measurements were taken of the notch. Demographic data for each patient were recorded including age, gender, height, weight, and BMI. Three categories of notch shape were established: 1. A-shaped; 2. U-shaped; and 3. W-shaped. Two blinded independent orthopedic surgeons were asked to categorize the recorded notches. Notch shape, dimensions, and demographic factors were correlated. Of the 102 notches evaluated, 55 notches were found to be “A-shaped,” 42 “U-shaped,” and 5 “W-shaped.” “A-shaped” notches were narrower in all width dimensions than “U-shaped” notches. Only patient height was found to influence notch shape with a positive association between taller patients and “U-shaped” and “W-shaped” notches (P = 0.011). Women had a smaller notch width at the base and middle of the notch. With this data, surgeons who enter the knee and appreciate an “A-shaped” notch should consider placing the arthroscope in the anteromedial portal and drill the femoral tunnel through an accessory medial portal to improve visualization and accuracy in anatomic femoral tunnel creation.

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Acknowledgments

The authors would like to thank James J. Irrgang, PT, PhD, ATC, FAPTA, for his helpful discussion in the preparation of this work. The authors did not receive any outside funding or grants directly related to the research presented in this manuscript. Our department receives funding from Smith and Nephew to support research related to reconstruction of the ACL. The research that forms the basis for this manuscript was done at our institution.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA

    Carola F. van Eck, Cesar A. Q. Martins, Shail M. Vyas, Umberto Celentano & Freddie H. Fu

  2. Orthopaedic Research Centre Amsterdam, Academic Medical Center, Meibergdreef 9, 1100, Amsterdam, The Netherlands

    Carola F. van Eck & C. Niek van Dijk

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  1. Carola F. van Eck
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  2. Cesar A. Q. Martins
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  3. Shail M. Vyas
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  4. Umberto Celentano
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  5. C. Niek van Dijk
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  6. Freddie H. Fu
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Correspondence to Freddie H. Fu.

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van Eck, C.F., Martins, C.A.Q., Vyas, S.M. et al. Femoral intercondylar notch shape and dimensions in ACL-injured patients. Knee Surg Sports Traumatol Arthrosc 18, 1257–1262 (2010). https://doi.org/10.1007/s00167-010-1135-z

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  • DOI: https://doi.org/10.1007/s00167-010-1135-z

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