2019 The Orthopaedic Journal of Sports Medicine
Meniscal ramp lesions are becoming increasingly recognized. Ramp lesions have been described as tears at the posterior meniscocapsular junction and/or tears of the posterior meniscotibial ligament, and they have a reported incidence of 16% to 40% of all anterior cruciate ligament (ACL) tears. Based on their location, these lesions may be arthroscopically “hidden” during normal anterior viewing; thus, an accessory posteromedial portal is necessary to confirm or deny their presence. In addition, there is controversy regarding identification strategies and surgical treatment options (repair versus no treatment). Some authors have advocated for the surgical repair of all meniscal ramp lesions at the time of ACL reconstruction, owing to an increased risk of persistent instability and potential ACL reconstruction graft failure when not treated. However, given the vascularization of the capsule and the red-red zone of the meniscus some clinical studies have cited the potential for these tears to heal without surgical treatment. Therefore, the purpose of this research survey was to better understand the current trends in orthopaedic surgery regarding arthroscopic identification and treatment of medial meniscal ramp lesions at the time of ACL surgery.
