Soft-Tissue Notchplasty to Prevent Localized Arthrofibrosis in Anterior Cruciate Ligament Reconstruction.

Bischoff, Caleb J; Prenger, Brent A; Chou, Te-Feng Arthur; DeFroda, Steven F; Nuelle, Clayton W · Arthrosc Tech · 2025

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Abstract

Arthrofibrosis is a common complication after anterior cruciate ligament reconstruction (ACLR). An excessive fibrotic response from an inflamed joint can lead to pain, restricted knee range of motion, and functional limitations, often necessitating additional interventions such as manipulation under anesthesia or arthroscopic lysis of adhesions. This study introduces a soft-tissue notchplasty technique to potentially reduce the risk of adhesions and cyclops lesion formation, both of which are major contributors to loss of knee range of motion. By selectively debriding the excessive, inflamed synovium and fibrotic tissue in the intercondylar notch, this technique provides a proactive approach to preventing soft-tissue adhesions. As ACLR techniques continue to evolve, incorporating soft-tissue notchplasty into routine practice may reduce localized arthrofibrosis and cyclops lesion formation and subsequent procedures after ACLR.