Harrell Maxwell, Rahaman Clay, Dayal Dev, Elliott Patrick, Manush Andrew, Brock Caleb, Brabston Eugene, Evely Thomas, Casp Aaron, Momaya Amit M
University of Alabama at Birmingham, Department of Orthopaedic Surgery, Birmingham, AL, USA.
University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, USA.
J Orthop. 2024 Dec 28;66:54-59. doi: 10.1016/j.jor.2024.12.040. eCollection 2025 Aug.
Notchplasty is an adjuvant procedure performed during Anterior Cruciate Ligament reconstruction (ACLR) with the purpose of widening the intercondylar notch of the femur. Its use is controversial due to its biomechanical influence on the knee and the potential for increased complications. The purpose of this systematic review is to evaluate the outcomes of patients who underwent ACLR with notchplasty.
A systematic search of Cochrane, Embase, and Medline was conducted to identify papers evaluating clinical outcomes of patients who underwent ACLR with notchplasty. Inclusion criteria encompassed human studies with a control group, reporting clinical outcomes such as graft failure, graft rupture, range of motion values, and patient-reported outcomes.
A total of 4 studies were included comprising 396 patients (129 with notchplasty, 235 without). No significant differences were reported regarding graft survivability or Lysholm score between those with notchplasty and those without. One study reported significantly reduced rates of revision surgery after ACLR with notchplasty. There were conflicting complication rates between studies regarding chronic synovitis and arthrofibrosis.
Patients who undergo notchplasty during primary ACLR have similar outcome scores and risk of graft failure compared to those who do not undergo notchplasty. Notchplasty patients may also be at a higher risk for loss of extension and chronic synovitis.
髁间切迹成形术是在前交叉韧带重建（ACLR）过程中进行的一种辅助手术，目的是扩大股骨髁间切迹。由于其对膝关节的生物力学影响以及并发症增加的可能性，其应用存在争议。本系统评价的目的是评估接受ACLR联合髁间切迹成形术患者的治疗效果。
对Cochrane、Embase和Medline进行系统检索，以确定评估接受ACLR联合髁间切迹成形术患者临床结局的论文。纳入标准包括有对照组的人体研究，报告诸如移植物失败、移植物破裂、活动度值和患者报告结局等临床结局。
共纳入4项研究，包括396例患者（129例行髁间切迹成形术，235例未行）。髁间切迹成形术患者与未行髁间切迹成形术患者在移植物存活率或Lysholm评分方面未报告有显著差异。一项研究报告ACLR联合髁间切迹成形术后翻修手术率显著降低。各研究之间关于慢性滑膜炎和关节纤维化的并发症发生率存在矛盾。
与未行髁间切迹成形术的患者相比，初次ACLR期间行髁间切迹成形术的患者具有相似的结局评分和移植物失败风险。髁间切迹成形术患者在伸直受限和慢性滑膜炎方面的风险可能也更高。
