What is it about?
Ramp lesions have been described as tears of the posterior medial meniscus at the attachment of the capsule and occur during tears of the ACL. Their name derives from their appearance during arthroscopic surgery when viewing posteromedially, the capsular attachment to the posterior medial meniscus looks like a downward ramp. However, there is limited data on the actual definition of a ramp lesion. This paper examines the descriptive anatomy of the posterior horn of the medial meniscus.
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Why is it important?
We were able to reliably quantify the posterior medial mensicus anatomy pertaining to meniscal ramp lesions in cadaveric specimens. Hematoxylin and eosin (H&E) staining of both the capsular and tibial attachments to the posterior medial meniscus demonstrated similar collagen structure, cell distribution, cell density, and fiber directionality, indicating no histological differences. Thus, it appears that both of these structures have a single shared attachment which has not been previously described.
Perspectives
This information is important surgically to identify potential hidden lesions and also has clinical implications for inside-out meniscal repair instead of 2 separate repair techniques for meniscocapsular and meniscotibial attachment tears. This article has led our group to re-define what constitutes a meniscal ramp lesion and provides a foundation for future biomechanical and clinical outcomes studies.
Nicholas DePhillipo
The Steadman Clinic
Read the Original
This page is a summary of: Quantitative and Qualitative Assessment of the Posterior Medial Meniscus Anatomy: Defining Meniscal Ramp Lesions, The American Journal of Sports Medicine, December 2018, SAGE Publications,
DOI: 10.1177/0363546518814258.
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