Meniscal ramp lesions: Anatomy, biomechanics, and clinical outcomes

Abstract

Introduction: Anterior cruciate ligament (ACL) tears are the most common researched pathology in all of sports medicine. Researchers and clinicians have dedicated their careers to investigating the treatment of ACL tears and why ACL reconstructions fail. The medial meniscus is a known secondary stabilizer to the ACL and recent clinical studies have reported that meniscal deficiency is the most significant factor to predict ACL reconstruction graft failure. Meniscal ramp lesions, originally defined as peripheral tears of the posterior horn of the medial meniscus, have been reported to occur in roughly a quarter of all patients who suffer an ACL tear and have become increasingly recognized in the field of sports medicine over the past decade. However, controversy exists regarding identification and treatment of these lesions and a consensus has yet to be made on their exact biomechanical role in ACL deficient and ACL reconstructed knees.

Paper I: Incidence and Detection of Meniscal Ramp Lesions in Anterior Cruciate Ligament Reconstruction Patients. DePhillipo NN, Cinque ME, Chahla J, Geeslin AG, Engebretsen L, LaPrade RF. Am J Sports Med. 2017 Aug;45(10):2233-2237.

Paper II: Quantitative and Qualitative Assessment of the Posterior Medial Meniscus Anatomy: Defining Meniscal Ramp Lesions. DePhillipo NN, Moatshe G, Chahla J, Aman ZS, Storaci HW, Morris ER, Robbins CM, Engebretsen L, LaPrade RF. Am J Sports Med. 2019 Feb; 47(2):372-378.

Paper III: Effect of Meniscocapsular and Meniscotibial Lesions in ACL-Deficient and ACL-Reconstructed Knees: A Biomechanical Study. DePhillipo NN, Moatshe G, Brady A, Chahla J, Aman ZS, Dornan GJ, Nakama GY, Engebretsen L, LaPrade RF. Am J Sports Med. 2018 Aug;46(10):2422-2431.

Paper IV: Current Trends Among U.S. Surgeons in the Identification, Treatment, and Time of Repair for Medial Meniscal Ramp Lesions at Time of ACL Surgery. DePhillipo NN, Engebretsen L, LaPrade RF. Orth J Sports Med. 2019 Feb 22;7(2).

Paper V: Clinical Characteristics and Outcomes Following Primary ACL Reconstruction and Meniscal Ramp Repair. DePhillipo NN, Dornan GJ, Dekker TJ, Aman ZS, Engebretsen L, LaPrade RF. Knee Surg & Sports Traum. Under review.