2025 ISAKOS Biennial Congress Paper
Meniscal Ramp Lesions Are Common On Magnetic Resonance Imaging But Not At Arthroscopy In Patients With Anterior Cruciate Ligament Tears.
Erik Lerjefors, MD, Vänersborg, Västra Götaland SWEDEN
Riccardo Cristiani, MD, PhD, Stockholm SWEDEN
Christoffer von Essen, MD, PhD, Stockholm SWEDEN
Fredrik Johansson, MSc, Stockholm SWEDEN
Anders Stalman, MD, PhD, Associate Professor, Saltsjobaden, Sweden SWEDEN
Capio Artro Clinic / Karolinska Institute, Stockholm, SWEDEN
FDA Status Not Applicable
Summary
Meniscal ramp lesions are common on MRI in patients undergoing ACL reconstruction and associated with high (≥7) pre-injury Tegner activity scale and posteromedial tibial bone bruising.
Abstract
Purpose
To assess the prevalence of and factors associated with meniscal ramp lesions in patients with anterior cruciate ligament (ACL) tears.
Methods
All patients who underwent primary ACL reconstruction (ACLR) at the XXX (blinded for review), Stockholm, Sweden, during 2018 were evaluated. Preoperative magnetic resonance imaging (MRI) scans were reviewed searching for the presence of meniscal ramp lesions. Univariable and multivariable logistic regression analyses were used to evaluate associations between patient characteristics and concomitant knee injuries and the presence of meniscal ramp lesions on MRI. Surgical reports were reviewed for the presence and treatment of meniscal ramp lesions.
Results
Of the 579 patients included in the study (males 51.0%; mean age 28.4 ± 11.4), 254 (43.9%) meniscal ramp lesions were diagnosed on MRI and 57 (9.8%) were diagnosed at ACLR. Of the 57 meniscal ramp lesions encountered at surgery, 6 (10.5%) were left in situ, 3 (5.3%) were resected and 48 (84.2%) were repaired. In the univariable analyses, posteromedial tibial (PMT) bone bruising, high (≥7) pre-injury Tegner activity scale, isolated deep medial collateral ligament (dMCL) injuries and time elapsed from injury to MRI were associated with an increased likelihood of identifying meniscal ramp lesions on MRI. Multivariable logistic regression analysis indicated that only PMT bone bruising (odds radio [OR] 2.49, 95% confidence intervals [CI] 1.55-4.03; P < 0.001) and a high (≥7) pre-injury Tegner activity scale (OR 1.69, 95% CI 1.06-2.72; P = 0.027) increased the likelihood of exhibiting meniscal ramp lesions on MRI.
Conclusion
Meniscal ramp lesions were commonly detected on MRI in patients undergoing ACLR, though less frequently observed during surgery. These lesions were associated with a high (≥ 7) pre-injury Tegner activity scale and PMT bone bruising.