Fate of the lateral femoral notch following early anterior cruciate ligament reconstruction

Background: The goal of this longitudinal study was to investigate the fate of the lateral ferm-oral notch (LFN), which is frequently seen as an impaction fracture of the lateral femoral condyle in patients with anterior cruciate ligament (ACL) tears. Methods: Patients who underwent early ACL reconstruction between 2006 and 2010 were reviewed. If post-injury magnetic resonance images showed an LFN greater than 1.5 min in depth, patients with untreated LFN were followed. Two blinded observers performed quantitative and qualitative imaging analysis. Results: Sixteen patients (five women, 11 men) were available for follow-up nine years (six to 10 years) post-injury. The median defect area of the LFN significantly decreased from 23 cm(2) (range: 0.9-3.8 cm(2)) to 1.6 cm(2) (range: 0.4-32 cm(2)) (P < .001). The defect depth did not significantly change from 2.3 mm (range: 2.0-3.6 mm) to 2.5 mm (range: 13-3.6 mm) (P > .05). The International Cartilage Repair Society (ICRS) score increased from 1.5 (range: 0-3) post-injury to 2.0 (range: 0-4) at follow-up (P < .01). The Lysholm score was 93 (72-100), the Tegner activity level was 6 (3-9) and the knee injury and osteoarthritis outcome score (KOOS) score was 97 (91-100). Conclusions: The defect area of the LFN decreased overtime, whereas the depth of the impression remained. Focal cartilage lesions were found in all except two patients post-injury and progressed during follow-up. However, patient-reported outcome scores were satisfying. (C) 2020 Elsevier B.V. All rights reserved.