Findings of irregularity at the posterior margin (p = 0.001) and complete fluid filling between the posterior horn of the medial meniscus and the capsule margin (p = 0.004) on magnetic resonance imaging were significantly associated with the presence of a ramp lesion. Inter-rater reliability between three reviewers was moderate at 0.56. The study also reported that younger patients more commonly have ramp lesions and recommend routine evaluation with a posteromedial viewing portal, as implications in missing a ramp lesion may be significant . Meniscal ramp lesions have been defined as longitudinal vertical peripheral tears of the medial meniscus involving the posterior meniscocapsular ligament, meniscotibial ligament, and/or the red-red zone of the posterior horn. -, Am J Sports Med. ment (ACL) lesion (t ermed “ Ramp Lesion ”,b yS t r o b e l et al. The findings are analyzed, classified and interpreted in the scientific context. Meta-regression analyses were performed to identify potential sources of heterogeneity. Greif DN, Baraga MG, Rizzo MG, et al. Background: Mobility at probing is very low. Nguyen JC, Bram JT, Lawrence JTR, Hong S, Leska TM, Ganley TJ, Ho-Fung V. AJR Am J Roentgenol. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. It has been reported to play a key role in the anterior tibial translation the knee joint. Epub 2017 Mar 25. Purpose (i) To investigate the frequency and natural evolution of meniscal ramp lesions (MRLs) on MRI in subjects with acute ACL tear and (ii) to compare knee cartilage compositional degeneration between subjects with MRLs and subjects without meniscal pathology over 2 years. Conversely, 12 patients had a ramp lesion detected on the MRI, which could not be confirmed intraoperatively. They also often remain undiagnosed when viewing from the standard anterior compartment arthroscopic portals. Pivot-shift injury caused by valgus stress to flexed and externally rotated knee. 2015 Dec;135(12):1701-6 The MFL was not observed in five (19%) of 26 studies of an LMRT. This is compounded by the fact that ramp lesions are also often overlooked during conventional anterior portal arthroscopy when direct visualization is not achieved. Greif, Dylan N., et al. Epub 2018 May 30. Medial meniscus ramp lesion repair with knee scorpion suture device from posteromedial portal in a ... read more ↘. It is known that their presence in ACL-deficient knees is related to instability and if they are not repaired during ACL reconstruction, they can ultimately cause the failure of the graft. They are strongly associated with acute and chronic anterior cruciate ligament (ACL) tears. The bone bruise involves the posterolateral tibial plateau and mid part of the lateral femoral condyle. Ramp lesions, which are commonly associated with ACL injuries and are often misdiagnosed, 1 disrupt the meniscotibial ligament and the posteromedial meniscus in the meniscocapsula A comprehensive search of the MEDLINE, Web of Science and Scopus databases was … Ramp Lesions of the Medial Meniscus (MM) are associated with 9 to 17% of ACL Tears and are seldom recognized on preoperative magnetic resonance imaging (MRI) scans. Meniscal tear | Radiology Reference Article | Radiopaedia.org Would you like email updates of new search results? 2017 Dec;103(8S):S237-S244. These lesions are stable and can be diagnosed only by a trans-notch approach. MRI appearance of the different meniscal ramp lesion types, with clinical and arthroscopic correlation. Negative predictive value was 91.1–97.4%, while positive predictive value was 50.0– 90.0%. [ 77 ]) still rema ins an understudi ed topic. Privacy, Help 38 Regardless of the … The study included 177 consecutive breast lesions (50 benign, 127 malignant) in 162 women. Seven ramp lesions were noted on arthroscopy (9%). Meniscal Ramp Lesions: What the Radiologist Needs to Know. Diagnostic performance studies using MRI as the index test and arthroscopy as the reference standard for ramp lesion were included. Meniscal ramp lesions are a special type of injury that affects the periphery of the posterior horn of the medial meniscus (PHMM) and/or its meniscocapsular attachments. MRI. Copyright © 2021 Elsevier B.V. or its licensors or contributors. doi: 10.1016/j.otsr.2017.08.003. By sheetal gupta 3 Videos FEATURING sheetal gupta. Purpose: Diagnostic performance studies using MRI as the index test and arthroscopy as the reference standard for ramp lesion were included. Routine arthroscopic assessment is recommended for the presence of ramp lesion, regardless of whether it is suspected on MRI. Accessibility By Alper Kaya 4 Videos. Ramp lesions are difficult to diagnose in imaging modality and are under-recognized when using standard anterolateral and anteromedial arthroscopic portals even with probe test. Ramp Lesions (RL) are also often described as meniscocapsular separations and meniscosynovial tears [ 13 ]. This site needs JavaScript to work properly. Ramp lesions, whose name reflects the ramp-like appearance of the posteromedial zone, are a particular type of injury within the posterior horn of the medial meniscus and its meniscocapsular attachments [ 3 ]. • Whether any longitudinal tear (ramp lesion) • State of posterolateral corner • Size/position of footprint and diameter of ligament for ACL reconstruction PARTIAL TEARS Some ACL's do not look frankly ruptured, but appear discontinuous, kinked or otherwise abnormal. -, Arch Orthop Trauma Surg. 2021 Mar 12;10(4):e1073-e1077. Lateral meniscus extrusion was present in six (23%) of 26 LMRTs and five (2.2%) of 231 patients with normal meniscus roots ( P < .001). DePhillipo NN, Moatshe G, Brady A, Chahla J, Aman ZS, Dornan GJ, Nakama GY, Engebretsen L, LaPrade RF. The sensitivity of MRI was 57% and the positive predictive value was 40%. Login to view comments. RAMP lesion of knee is menisco-capsular separation of medial meniscus and needs to be repaired to provide better rotational stability to knee Epub 2021 Jan 13. FOIA Arthrosc Tech. Ramp lesion type V. Get link; Facebook; Twitter; Pinterest; Email; Other Apps; Por Dr Vinícius Chissini Paganella - September 24, 2020 MRI. Further clinicoradiological studies of diagnostic algorithms are needed for identifying ramp lesion, including high-resolution MRI with appropriate knee position. They are heavily associated with anterior cruciate ligament injuries, and because of their potentially important biomechanical role in knee stabilization, injuries to this region may require surgical repair. By Alper Kaya 4 Videos. Anecdotally, we have found that musculoskeletal radiologists are often unaware of the MRI pattern of this, occasionally subtle, injury to the sMCL of the knee and the associated surgical implications. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Meniscal Ramp Lesions: What the Radiologist Needs to Know. Stratified subgroup analysis and multivariable regression analysis were performed to identify factors … Unable to load your collection due to an error, Unable to load your delegates due to an error. sports injury knee sports radiology Posterior meniscal ramp lesions: insufficiently known or underestimated? Overlooking such lesions during ACLR may contribute to ongoing instability and higher re-rupture rates in these young patients. 2019 Nov;47(13):3195-3202 abstract = "Background: Meniscal ramp lesions have been defined as longitudinal vertical peripheral tears of the medial meniscus involving the posterior meniscocapsular ligament, meniscotibial ligament, and/or the red-red zone of the posterior horn. https://doi.org/10.1016/j.acra.2021.02.005. The objective of this article is to review the recent literature regarding meniscal ramp lesions and to summarize the anatomical, biomechanical and fundamentally diagnostic aspects, emphasizing the radiological findings described until now. RAMP MRI (23 benign, 61 malignant) and DCE MRI examinations (27 benign, 66 malignant) demonstrated 8.4% vs. 9.3% washout (p=0.36) for benign lesions and 18.5% vs. 17% washout (p=0.66) for malignancies, respectively.There was no difference in the … They also often remain undiagnosed when viewing from the standard anterior compartment arthroscopic portals. Sensitivity of detecting a ramp lesion on MRI ranged from 53.9 to 84.6%, while specificity was 92.3–98.7%. Although knee Stener-like lesions have been previously described in the orthopedic literature [11–13, 16, 17], we are unaware of any reports in the radiology literature. Effect of Meniscocapsular and Meniscotibial Lesions in ACL-Deficient and ACL-Reconstructed Knees: A Biomechanical Study. 2017. Ramp lesions may be classified into 5 types according to their morphology ( Fig. 2012 Oct;40(10):2342-7 47, No. Results: Seven ramp lesions were noted on arthroscopy (9%). The coexistence of ACL rupture and other knee injur- 2015 Oct;23(10):2967-73 AX PD FS. Ramp lesion Browsing. By reducing scan time, the RAMP MRI protocol improves patient comfort and enhances workflow efficiency and can … Results: Sixteen ramp lesions were noted on arthroscopy (37.2%). Since this type of injury is often underdiagnosed due to its localization at the “blind” point of arthroscopic vision, it is crucial to make an accurate preoperative diagnosis of them with MRI. Knees in which a ramp lesion was observed were significantly more likely to have MRI findings of a medial meniscus tear (p = .005), peripheral meniscal irregularity (p = .001), junctional T2-weighted signal (p < .001), and a meniscocapsular ligament tear (p < .001). MRI Criteria for Meniscal Ramp Lesions of the Knee in Children With Anterior Cruciate Ligament Tears. A ramp lesion is a disruption in the meniscocapsular attachments of the medial meniscus (MM) posterior horn (PH) and is characterized by a superior meniscocapsular or inferior meniscotibial ligament tear, or both [ 1, 2, 3, 4, 5 ]. We use cookies to help provide and enhance our service and tailor content and ads. In the ScienceCast series "Knee", Elmar Herbst regularly assesses new publications in the field of knee surgery and discusses these together with a guest expert. Im Rahmen einer anterioren Routinekniegelenkspiegelung und durch die präoperative radiologische Diagnostik können sie nur eingeschränkt bis gar nicht diagnostiziert werden. young patient with chronic ACL deficient knee. By continuing you agree to the use of cookies. Results: Sixteen ramp lesions were noted on arthroscopy (37.2%). Results. Medial meniscus; Meniscocapsular ligament; Meniscotibial ligament; Posterior horn; Ramp lesions. MRI has a low sensitivity for diagnosis of ramp lesions in children. young patient with chronic ACL deficient knee. Knee; Joelho MRI. ObjectiveTo identify the findings on magnetic resonance imaging most strongly associated with meniscal ramp lesions in patients with an anterior cruciate ligament tear.Subjects and methodsSeventy-eight consecutive patients (mean age, 33.7 years; 64 male, 14 female) with an arthroscopically proven anterior cruciate ligament tear were included in this retrospective study. Double vertical tear seen in posterior horn medial meniscus. Am J Sports Med. MRI has a low sensitivity for diagnosis of ramp lesions in children. MR Imaging–based Diagnosis and Classification of Meniscal Tears. Originally, a ramp lesion was defined as a longitudinal tear of the peripheral attachment of the posterior horn of the medial meniscus at the meniscocapsular junction of less than 2.5 cm in length.26 However, recent literature has sug- Thank you. Discussion: Pivot-shift injury caused by valgus stress to flexed and externally rotated knee. Tears involving the posterior meniscocapsular zone, including at the meniscocapsular junction, are also termed “Ramp” lesions, first described by Strobel et al in the 1980s 1. ↖ read less. 26 However, recent literature has suggested that ramp lesions are associated with injury to the meniscotibial ligament attachment of the posterior horn of the medial meniscus. Ramp Lesions of the Medial Meniscus (MM) are associated with 9 to 17% of ACL Tears and are seldom recognized on preoperative magnetic resonance imaging (MRI) scans. Complex or deep radial tears were found in three of five cases of lateral meniscus extrusion and normal root. Meniscal Ramp lesions are frequently associated with Anterior Cruciate Ligament ruptures. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed.
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