title: Meniscal Ramp Lesions: Anatomy, Incidence, Diagnosis, and Treatment.
abstract: Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol.
authors: The Steadman Philippon Research Institute, Vail, Colorado, USA.
authors: Jorge
authors: J
authors: Chahla
authors: The Steadman Philippon Research Institute, Vail, Colorado, USA.
authors: Chase S
authors: CS
authors: Dean
authors: The Steadman Philippon Research Institute, Vail, Colorado, USA.; Department of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway.; OSRTC, The Norwegian School of Sports Sciences, Oslo, Norway.
authors: Gilbert
authors: G
authors: Moatshe
authors: The Steadman Philippon Research Institute, Vail, Colorado, USA.; The Steadman Clinic, Vail, Colorado, USA.
authors: Justin J
authors: JJ
authors: Mitchell
authors: The Steadman Philippon Research Institute, Vail, Colorado, USA.
authors: Tyler R
authors: TR
authors: Cram
authors: The Steadman Philippon Research Institute, Vail, Colorado, USA.
authors: Carlos
authors: C
authors: Yacuzzi
authors: The Steadman Philippon Research Institute, Vail, Colorado, USA.; The Steadman Clinic, Vail, Colorado, USA.
authors: Robert F
authors: RF
authors: LaPrade
keywords: ACL; hidden lesion; meniscocapsular; meniscus tear; ramp lesion