Surgical Treatment of Meniscal RAMP Lesion

Gülenç, Barış; Kemah, Bahattin; Yalçın, Sercan; Sayar, Şafak; Korkmaz, Oğuzhan; Erdil, Mehmet

doi:10.1055/s-0039-1677887

Cited by 15 publications

(22 citation statements)

References 29 publications

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“…PHMM is known to have secondary effect of limiting anterior translation of tibia [10]. Ramp lesion repairing significantly increases postoperative knee function following ACL reconstruction [11].…”

Section: Discussionmentioning

confidence: 99%

Isolated meniscal ramp lesion without obvious ACL rupture

Jiang¹,

Ni²,

Chen³

2020

Preprint

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Background To study isolated meniscal ramp lesion without obvious ACL rupture, analysis its clinical characteristics and evaluate clinical effect of all-inside horizontal mattress suture. Methods From 2015-2017, there are 20 isolated meniscal ramp lesion patients without obvious ACL rupture in our hospital. These isolated ramp lesions were arthroscopically repaired through all-inside horizontal mattress suturing method with 12 0 Mitek Omnispan meniscal repairing system. MRI was performed preoperatively and postoperatively 3 months later during follow-up. The Tegner-lysholm score and VAS score were recorded preoperatively and postoperatively at 2 years follow-up. T-test was performed to detect statistical significance. Results MRI postoperatively 3 months later shows healing of the isolated ramp lesion. Postoperatively at 2 years follow-up, VAS score was significantly decreased and Tegner-lysholm score was significantly raised comparing preoperatively. All patients recover their knee function without pain, including walking, stairs climbing and descending, squatting et al. Conclusion Isolated meniscal ramp lesion without obvious ACL rupture may exist because of ACL longitudinal splits. Through all-inside horizontal mattress suturing method with 12 0 Mitek Omnispan meniscal repairing system, isolated ramp lesion can be repaired through routine anterolateral and anteromedial portal.

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Section: Discussionmentioning

confidence: 99%

Isolated meniscal ramp lesion without obvious ACL rupture

Jiang¹,

Ni²,

Chen³

2020

Preprint

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“…Initial search through the databases retrieved 1102 articles. A total of 16 original research articles were included in the systematic review, eight studies were included in the diagnostic analysis and nine studies were included in the treatment analysis, with one study [28] being included in both portions.…”

Section: Literature Searchmentioning

confidence: 99%

“…All studies present different postoperative rehabilitation protocols, with many common key points. All patients were followed for a minimum of 12 months, except in the study by Gulenc et al [28] (33 weeks).…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…2, all studies satisfied at least six of the 11 items recommended by the QUADAS-2 tool. Three studies were considered of low quality concerning the representativeness of the spectrum of patients, as a result of the study of a paediatric population [48] or the study of patients already diagnosed with Ramp Lesions [22,28]. The interval between MRI and the reference standard was absent in three studies [38,40,48].…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Study selection process for the Systematic Review using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Gulenc et al[28] was included in both portions of the analysis…”

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confidence: 99%

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Ramp lesions: a systematic review of MRI diagnostic accuracy and treatment efficacy

Moreira¹,

Almeida²,

Lunet³

et al. 2020

J EXP ORTOP

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Purpose We conducted a systematic review of the published literature to assess the accuracy of Magnetic Resonance Imaging (MRI) in establishing the presence of ramp lesions (RLs) in Anterior Cruciate Ligament (ACL) deficient knees and the clinical efficacy of the surgical repair of RLs. Methods A comprehensive search of the MEDLINE, Web of Science and Scopus databases was performed according to PRISMA guidelines. Studies assessing MRI diagnostic accuracy for RLs or the clinical effect of RL repair in participants with ACL injuries were included. Diagnostic accuracy measures were pooled and plotted in forest plots. Preoperative and at last follow-up treatment efficacy outcome measures were extracted and plotted in forest plots, for graphical comprehension. Results Sixteen studies met the criteria and were included. The diagnostic analysis showed a pooled sensitivity, specificity, positive and negative likelihood ratios of 65.1% (95% CI, 59.73 to 70.42), 91.6% (95% CI, 89.14 to 94.05), 2.91 (95% CI, 2.38–3.55) and 0.53 (95% CI, 0.44–0.64), respectively, with high heterogeneity (I2 above 80%) for all measures. Treatment analysis showed improved Lysholm Knee Score, IKDC score and laxity difference between the knees in all studies after meniscal suture repair. A separate analysis showed no differences between repair of smaller, stable, RLs with meniscal sutures and repair with abrasion and trephination only. Conclusion Although the results present considerable heterogeneity, MRI seems to demonstrate moderate accuracy in the diagnosis of RLs in patients with ACL tear and the surgical repair of RLs can be associated with improved overall outcomes.

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