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Leaving the stable ramp lesion unrepaired does not negatively affect clinical and functional outcomes as well as return to sports rates after ACL reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate the effects of untreated stable ramp lesions on clinical and functional outcomes, return to sports rates, and complications of patients who underwent anterior cruciate ligament reconstruction.

Methods

A total of 879 patients with anterior cruciate ligament rupture were evaluated. Of these, 66 patients [33 patients with anterior cruciate ligament rupture and stable medial meniscal ramp lesion (ramp + group) and 33 patients with isolated anterior cruciate ligament rupture (ramp − group)] with a minimum 3-year of follow-up were included. Stable ramp lesions were not repaired in the ramp + group. Preoperative and postoperative Lachman and pivot-shift grades, Lysholm knee scores, International Knee Documentation Committee score and 12-Item Short Form Health Survey score were compared between groups. The return to sports rates, level of return to sports, time to return to sports and complications were compared.

Results

The mean patient age was 27.8 ± 7.2 years. The mean follow-up period was 47.3 ± 9.4 months. There were no significant differences between groups regarding preoperative and postoperative Lachman and pivot-shift grades, 12-Item Short Form Health Survey mental and physical component summary scores, Lysholm and International Knee Documentation Committee scores, and complication rates (n.s.). Although the return to sports rates (84.8% vs 90.1%) and the level of the return to sports (return to preinjury level: 75% vs 78%) were similar between groups (n.s.), the time to return to sports was significantly longer for patients with ramp lesions (11.1 ± 4.0 vs. 8.7 ± 2.5 months, p = 0.007).

Conclusion

Leaving the stable ramp lesion unrepaired does not negatively affect clinical and functional outcomes as well as return to sports rates after ACL reconstruction. However, the time to return to sports is prolonged in patients with ramp lesions In clinical practice, surgeons should be aware that repairing stable ramp lesions is not an absolute necessity and will not affect return to sport rates.

Level of evidence

Level III.

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Authors and Affiliations

  1. Department of Orthopedics and Traumatology, University of Health Sciences Haseki Training and Research Hospital, Istanbul, Turkey

    Kutalmis Albayrak

  2. Department of Orthopedics and Traumatology, University of Health Sciences Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey

    Mehmet Ozbey Buyukkuscu & Abdulhamit Misir

  3. Department of Orthopaedics and Traumatology, University of Health Sciences Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey

    Muhammed Bilal Kurk, Ozan Kaya & Ahmet Kulduk

Authors
  1. Kutalmis Albayrak
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  2. Mehmet Ozbey Buyukkuscu
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  3. Muhammed Bilal Kurk
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  4. Ozan Kaya
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  5. Ahmet Kulduk
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  6. Abdulhamit Misir
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Corresponding author

Correspondence to Kutalmis Albayrak.

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Conflict of interest

Kutalmis Albayrak, Mehmet Ozbey Buyukkuscu, Muhammed Bilal Kurk, Ozan Kaya, Ahmet Kulduk and Abdulhamit Misir declare that they have no conflict of interest.

Funding

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical approval

University of Health Sciences Baltalimani Bone Diseases Training and Research Hospital institutional review board approved the study protocol (no. 44/318).

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An informed consent was obtained from all the patients.

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Albayrak, K., Buyukkuscu, M.O., Kurk, M.B. et al. Leaving the stable ramp lesion unrepaired does not negatively affect clinical and functional outcomes as well as return to sports rates after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 29, 3773–3781 (2021). https://doi.org/10.1007/s00167-020-06402-w

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  • DOI: https://doi.org/10.1007/s00167-020-06402-w

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