Editorial Commentary: Are Intercondylar Notch Osteophytes Predictors of Anterior Cruciate Ligament Injuries?

The cause of anterior cruciate ligament (ACL) tears is multifactorial. Intrinsic and extrinsic factors are known. Particularly, intrinsic factors can be analyzed and used to assess the potential risk of ACL injuries. Anatomical, hormonal, neuromuscular, and biomechanical determinants are described in this context. Previous studies show sex-related differences, with women having a higher risk of ACL tears than men. With regard to intrinsic anatomical factors, intercondylar notch stenosis has been described as a potential risk factor for ACL injury. Therefore, the quantitative assessment of morphometric parameters (including osteophytes) of the intercondylar notch using 3-dimensional computed tomography reconstruction and the analysis of their correlation with ACL injuries are very important and valuable for preoperative evaluation of an individualized ACL reconstruction approach including widening and reshaping of the intercondylar notch as well as resection of intercondylar notch osteophytes like a notchplasty, if necessary. This may lead to a decrease of ACL rerupture rates by protecting the graft structure and to an improvement of postoperative clinical outcomes, especially with regard to knee extension deficits. Additionally, it might improve patient counseling, risk assessment for ACL injuries, and the further development of ACL injury prevention strategies.