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Arthroscopic Meniscal Ramp Tear Repair

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Knee Arthroscopy and Knee Preservation Surgery

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Abstract

Ramp lesions of the posterior horn of the medial meniscus have received increased attention over the last decade due to their high prevalence in patients undergoing anterior cruciate ligament reconstruction. The diagnosis of these lesions is not reliable with preoperative imaging and quite limited with routine anterior arthroscopic inspection of the knee joint. Visual inspection of the posteromedial compartment of the knee joint should thus systematically be carried out via a trans-notch view and probing of the meniscocapsular structures with a needle or direct visualization via an additional posteromedial viewing portal. While the clinical impact of ramp lesions has not yet been well established, recent biomechanical studies have shown increased anteroposterior and rotational laxities in the presence of a ramp lesion. Leaving these lesions untreated may thus impact ACL reconstruction outcomes leading to postoperative residual laxity with potential failure of the graft or a secondary lesion of the medial meniscus. To date, it remains unclear whether all ramp lesions should be repaired as only a few publications report long-term outcomes. This chapter provides an overview of the current knowledge of ramp lesions including their diagnosis, classification, biomechanical relevance as well as treatment options and outcomes.

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology St. Marguerite Hospital, Institute for Movement and Locomotion (IML), Marseille, France

    Christophe Jacquet

  2. Sports Clinic, Centre Hospitalier de Luxembourg – Clinique d’Eich, Luxembourg City, Luxembourg

    Caroline Mouton & Romain Seil

  3. Luxembourg Institute of Research in Orthopaedics, Sports Medicine and Science (LIROMS), Luxembourg City, Luxembourg

    Caroline Mouton & Romain Seil

  4. Center for Musculoskeletal Surgery Osnabrück (OZMC), Klinikum Osnabrück Osnabrück, Osnabrueck, Germany

    Markus Kracke

  5. Human Motion, Orthopaedics, Sports Medicine and Digital Methods (HOSD), Luxembourg Institute of Health, Strassen, Luxembourg

    Romain Seil

Authors
  1. Christophe Jacquet
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  2. Caroline Mouton
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  3. Markus Kracke
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  4. Romain Seil
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Corresponding author

Correspondence to Romain Seil .

Editor information

Editors and Affiliations

  1. Sports Medicine Clinic, Stanford University, Redwood City, CA, USA

    Seth L. Sherman

  2. Midwest Orthopedics, Rush University, Chicago, IL, USA

    Jorge Chahla

  3. Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA

    Scott A. Rodeo

  4. Complex Knee and Sports Medicine Surgeon, Twin Cities Spine Center, Edina, MN, USA

    Robert LaPrade

Section Editor information

  1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA

    Aaron J. Krych

  2. Research Foundation, Centers for Advanced Orthopaedics (CAO), Washington, DC, USA

    Scott C. Faucett

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Jacquet, C., Mouton, C., Kracke, M., Seil, R. (2023). Arthroscopic Meniscal Ramp Tear Repair. In: Sherman, S.L., Chahla, J., Rodeo, S.A., LaPrade, R. (eds) Knee Arthroscopy and Knee Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-82869-1_28-1

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  • DOI: https://doi.org/10.1007/978-3-030-82869-1_28-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-82869-1

  • Online ISBN: 978-3-030-82869-1

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