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Clinical evaluation indicates notch dimensions and graft volume dictate impingement risk in ACL reconstruction, highlighting that notchplasty decisions depend on both notch size and content.
A stenotic intercondylar notch is an indication for a notchplasty at the time of ACL reconstructive surgery. However, the absence of a stenotic notch does not ensure that impingement of the ligament upon the intercondylar notch will not occur. An excessively large ligament, even in the presence of a normal intercondylar notch, will result in abrasion of the ligament on the notch. This can result in the premature failure of the reconstructed ACL. Therefore, both the notch size and notch content are important determinants in assessing whether a notchplasty is required as part of the ACL reconstructive procedure.
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Tänzer et al. (1990) studied this question.
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