Ramp lesions associated with ACL injuries are more likely to be present in contact injuries and complete ACL tears

Knee Surg Sports Traumatol Arthrosc. 2018 Apr;26(4):1080-1085. doi: 10.1007/s00167-017-4598-3. Epub 2017 Jun 21.

Abstract

Purpose: The purpose of this study was to analyse patient and injury characteristics as well as arthroscopic findings in a prospective cohort of ACL-injured patients with or without an associated ramp lesion.

Methods: Two hundred and twenty-four patients undergoing a primary (n = 196) or revision (n = 28) ACL reconstruction were included. The presence of a ramp lesion was determined by a systematic arthroscopic inspection of the posteromedial compartment. Chi-square tests were used to compare the population of ACL-injured patients with and without a ramp lesion regarding sex, age, body mass index, previous ACL injuries, sport before injury, and injury characteristics. Significance was set at p < 0.05.

Results: Fifty-three out of 224 patients had a ramp lesion (24%). The presence of the latter was not related to any of the analysed patient characteristics. The prevalence of the lesion was higher in contact injuries (n = 19; 41%) compared with non-contact injures (n = 34; 19%; p < 0.001). It was higher in patients with complete ACL ruptures (n = 49; 27%) as opposed to partial ruptures (n = 1; 4%; p = 0.01). A patient was 2.98 [95% CI 1.49-5.98] times more likely to have a ramp lesion if the ACL injury was declared to have been caused by direct contact and 8.71 [95% CI 1.15-66.12] times more likely if the ACL tear was complete.

Conclusion: Ramp lesions may be anticipated in almost one out of four patients undergoing ACL reconstruction, especially if a patient sustained a contact injury and in the presence of a complete ACL tear.

Level of evidence: III.

Keywords: Anterior cruciate ligament; Epidemiology; Knee; Ramp lesion.

MeSH terms

  • Adult
  • Anterior Cruciate Ligament Injuries / complications*
  • Anterior Cruciate Ligament Injuries / surgery
  • Arthroscopy*
  • Athletic Injuries / complications
  • Athletic Injuries / surgery
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Rupture
  • Tibial Meniscus Injuries / complications*
  • Tibial Meniscus Injuries / surgery
  • Young Adult