Study Finds, Assciatin between Medial meniscal ramp lesions
A Study was conducted to describe demographic and anatomical risk factors for ramp lesions, and to identify concomitant lesions and define their characteristics to improve diagnosis of ramp lesions on MRI. Medial menisco-capsular separations (ramp lesions) are typically found in association with anterior cruciate ligament (ACL) deficiency. They are frequently missed preoperatively due to low MRI sensitivity.

The presence/absence of ramp lesions was recorded in preoperative MRIs and at surgery. Patients’ characteristics and clinical findings, concomitant injuries on MRI and the posterior tibial slope were evaluated.

--100 patients with a mean age of 22.3±4.9 years met the inclusion criteria. The incidence of ramp lesions diagnosed at surgery was 16%.

--Ramp lesions were strongly associated with injuries to the deep MCL (dMCL), the superficial medial collateral ligament (sMCL), and a small medial–lateral tibial slope asymmetry.

--There was also good correlation between ramp lesions and bone oedema in the posterior medial tibia plateau (MTP) and medial femoral condyle (MFC).

--A dMCL injury, a smaller differential medial–lateral tibial slope than usual, and the identification of a ramp lesion on MRI increases the likelihood of finding a ramp lesion at surgery.

--MRI sensitivity was 62.5% and the specificity was 84.5%.

Conclusively, the presence of sMCL and/or dMCL lesions on MRI, bone oedema in the posterior MTP and MFC, and a smaller medial–lateral tibial slope difference than typical are all strongly linked to ramp lesions. A dMCL injury, a flatter lateral tibial slope than usual, and the presence of a ramp lesion on MRI all increase the chances of a ramp lesion being discovered during surgery.