Beyond the ACL: The Hidden Impact of Ramp Tears on Knee Stability

نویسندگان
Soleymanha, Mehran ID 1
Movahedinia, Mohammad ID 2
LaPrade, Robert F. ID 3
Vosoughi, Fardis ID 4
Keyhani, Sohrab ID 5
Shirbache, Kamran ID 6
Menbari Oskouie, Iman ID 7
Tollefson, Luke V. ID 8
Verdonk, Rene ID 9
Aminizadeh, Sina ID 10

1 Poursina Orthopedic research center, Guilan University of Medical science, Guilan, Iran

2 Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Twin Cities Orthopedics, Edina, Minnesota, USA

4 Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

5 Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

6 Pediatric Orthopaedic Department, Hôpital Robert-Debré, Groupe Hospitalier Universitaire AP-HP Nord-Université Paris-Cité, Paris, France -Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran

7 Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

8 Twin Cities Orthopedics, Edina, Minnesota, USA

9 Department of Orthopedics, Ghent University Hospital, Ghent, Belgium

10 Department of Orthopaedics and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

doi
10.22038/abjs.2025.88267.3998
چکیده

Medial meniscus ramp lesions have emerged as a critical but frequently overlooked contributor to knee instability, particularly in the context of anterior cruciate ligament (ACL) injuries. Recent advances in imaging and arthroscopic techniques have improved their detection and classification, enhancing our understanding of their anatomical and functional significance. Evidence indicates that untreated ramp lesions may perpetuate instability and alter knee biomechanics, underscoring the need for structured, individualized treatment. Although multiple arthroscopic repair strategies have been proposed, the optimal technique remains debated. The posterior portals approach offers superior visualization and reliable repair, and has gained increasing adoption. This review synthesizes current insights into ramp lesion pathophysiology, classification, diagnostic advances, and evolving management strategies, emphasizing the importance of accurate identification and tailored intervention to optimize patient outcomes.         Level of evidence: IV

کلیدواژه‌ها
Anterior cruciate ligament (ACL) injury, Arthroscopic repair techniques, Knee Instability, Medial meniscus ramp lesion, Meniscal biomechanics, Posteromedial portal approach