Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 7;59(5):e702-e706.
doi: 10.1055/s-0044-1791791. eCollection 2024 Oct.

Meniscal Ramp Injury Diagnosis

Pedro Baches Jorge  1 , Diego Escudeiro de Oliveira  1 , Guilherme do Amaral Mussatto  1 , Melanie Mayumi Horita  1 , Victor Eduardo Roman Salas  1 , Rafael Baches Jorge  1
Affiliations

Meniscal Ramp Injury Diagnosis

Pedro Baches Jorge et al. Rev Bras Ortop (Sao Paulo). .

Abstract

Objective : This study compared diagnostic methods for meniscal ramp injury (magnetic resonance imaging [MRI], arthrotomography, and arthroscopy) to determine the most sensitive and the agreement level between them. Method: We studied 21 patients, all young athletes with suspected anterior cruciate ligament (ACL) injury after trauma for at least 3 months and no evidence or history of other osteoarticular injuries in the knee. The patients underwent MRI and arthrotomography. Following ACL injury confirmation, they underwent arthroscopy for ligament reconstruction and evaluation of the medial meniscus to confirm or exclude a ramp injury. McNemar's agreement test compared the diagnostic methods. We also assessed specificity and sensitivity using arthroscopy as the gold standard with a 95% confidence interval and p < 0.005. Result : The results were consistent with the literature. MRI had 73.3% sensitivity and 83.3% specificity, with 76.2% agreement with the gold standard. Arthrotomography sensitivity and specificity were 100% and 66.7%, respectively, with 90.5% agreement with arthroscopy. Conclusion : In our study, arthrotomography was the most sensitive diagnostic method and had the highest agreement with the gold standard. We recommend its consideration for diagnosing ACL injuries.

Keywords: anterior cruciate ligament injuries; arthroscopy; tibial meniscus injuries.

PubMed Disclaimer

Conflict of interest statement

Conflito de Interesses Os autores declaram não ter qualquer tipo de conflito de interesse.

Figures

Fig. 1
Fig. 1
Anatomical dissection of the left knee joint. Yellow arrows mark the posteromedial femoral recess. Medial collateral ligament (MCL), medial meniscus (MM), lateral meniscus (ML), joint capsule (JC), posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), and enlargement of the posteromedial femoral recess. Source: Śmigielski R, Becker R, Zdanowicz U, Ciszek B. Medial meniscus anatomy from basic science to treatment. Knee Surg Sports Traumatol Arthrosc 2015;23(1): 8-14.
Fig. 1
Fig. 1
Dissecção anatômica da articulação do joelho esquerdo. O recesso femoral póstero-medial é marcado com setas amarelas. Ligamento colateral medial (MCL), menisco medial (MM), menisco lateral (ML) cápsula articular (JC), ligamento cruzado posterior (PCL), ligamento cruzado anterior (ACL), ampliação do recesso femoral póstero-medial. Fonte: Śmigielski R, Becker R, Zdanowicz U, Ciszek B. Medial meniscus anatomy from basic science to treatment. Knee Surg Sports Traumatol Arthrosc 2015;23(1): 8-14.
See this image and copyright information in PMC

References

    1. Sonnery-Cottet B, Serra Cruz R, Vieira T D, Goes R A, Saithna A. Ramp Lesions: An Unrecognized Posteromedial Instability? Clin Sports Med. 2020;39(01):69–81. - PubMed
    1. Thaunat M, Fayard J M, Guimaraes T M, Jan N, Murphy C G, Sonnery-Cottet B. Classification and Surgical Repair of Ramp Lesions of the Medial Meniscus. Arthrosc Tech. 2016;5(04):e871–e875. - PMC - PubMed
    1. Hatayama K, Terauchi M, Saito K, Takase R, Higuchi H. Healing Status of Meniscal Ramp Lesion Affects Anterior Knee Stability After ACL Reconstruction. Orthop J Sports Med. 2020;8(05):2.325967120917674E15. - PMC - PubMed
    1. DePhillipo N N, Engebretsen L, LaPrade R F. Current Trends Among US Surgeons in the Identification, Treatment, and Time of Repair for Medial Meniscal Ramp Lesions at the Time of ACL Surgery. Orthop J Sports Med. 2019;7(02):2.325967119827267E15. - PMC - PubMed
    1. Kumar N S, Spencer T, Cote M P, Arciero R A, Edgar C. Is Edema at the Posterior Medial Tibial Plateau Indicative of a Ramp Lesion? An Examination of 307 Patients With Anterior Cruciate Ligament Reconstruction and Medial Meniscal Tears. Orthop J Sports Med. 2018;6(06):2.325967118780089E15. - PMC - PubMed

LinkOut - more resources