The intercondylar notch is the deep space in the knee between the two rounded ends (condyles) of the thighbone (femur).
Page updated June 2023 by Dr Sheila Strover (Clinical Editor)
Ligaments removed for illustrative purposes.
What is the intercondylar notch?
The notch serves to house and protect the two cruciate ligaments that tether femur and tibia centrally. During an arthroscopy surgeons may pass their instruments through the notch to observe the back of the knee cavity, including the area of the popliteus hiatus on the lateral side and the posterior meniscal roots on each side.
The intercondylar notch and the cruciate ligaments
The cruciate ligaments in the notch are critical knee stabilisers, and they are configured to allow bending and flexing of the knee in a simple arc, despite the fact that the condyles are more oval than round.
After cruciate ligament reconstruction, the new graft may be relatively fat and impinge on the roof of the notch as the knee goes into full extension. This may limit extension and may also cause some stripping back of the graft construct, creating a lump of tissue called a 'cyclops lesion', which may further restrict range of motion.
Narrowing of the intercondylar notch
A narrow intercondylar notch may predispose to cruciate ligament tears. It is often widened with a rotating burr during anterior cruciate ligament reconstruction in order to prevent any obstruction of the new ligament by the development of a cyclops lesion.
MRI measurements may help to predict those athletes that may be vulnerable to ACL tears. "ACL tears are associated with a small intercondylar notch width and a high α angle." One other "...important factor that may predispose a patient to an ACL tear is the relative angular position of the tibia with respect to the femur"
Citation: Fernández-Jaén T, López-Alcorocho JM, Rodriguez-Iñigo E, Castellán F, Hernández JC, Guillén-García P. The Importance of the Intercondylar Notch in Anterior Cruciate Ligament Tears. Orthop J Sports Med. 2015 Aug 5;3(8):2325967115597882. doi: 10.1177/2325967115597882. PMID: 26535388; PMCID: PMC4622305.
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Related material -
- Notch impingement
- Cyclops lesion
- Anterior cruciate ligament injury
- Anterior cruciate ligament reconstruction