The Influence of Intercondylar Notch Shape and Size on the Treatment Algorithm for Anatomic Anterior Cruciate Ligament Reconstruction

The intercondylar notch and anterior cruciate ligament (ACL) are closely related. Literature suggests that patients with a narrow intercondylar notch may be predisposed to ACL injury. However, the notch is also important during ACL reconstruction surgery. A narrow notch or A-shaped notch may make it difficult to drill the femoral tunnel from the medial portal and may not be able to accommodate a double-bundle technique. However, if these considerations are taken into account, a narrow notch does not predispose to ACL graft rupture. This article provides a historic overview of the research performed on the intercondylar notch as it related to ACL injury risk. In addition, it provides guidelines for intraoperative decision-making.