2023 ISAKOS Biennial Congress ePoster
Do All Meniscal Ramp Lesions Require Repair? A Prospective Study Of Ramp Lesions with Concomitant ACL Injury?
Silvampatti Ramasamy Sundararajan, MS(Orth), COIMBATORE, TAMILNADU INDIA
Terence Dsouza, MS, DNB, FNB, Coimbatore, TAMIL NADU INDIA
S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, Coimbatore, Tamil Nadu INDIA
Ganga Hospital, COIMBATORE, Tamil Nadu, INDIA
FDA Status Not Applicable
Summary
CONSERVATIVELY TREATED STABLE RAMP LESIONS HAVE COMPARABLE OUTCOMES AND STABILITY TO KNEES WITHOUT RAMP LESIONS DURING ACLR
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Abstract
Introduction
Ramp lesions are not uncommon injuries. However, their prevalence, diagnostic sensitivity of MRI in detecting them & treatment guidelines are still unclear. Our study aims at evaluating the prevalence of ramp lesions in patients undergoing ACL Reconstruction(ACLR), analyse the sensitivity of MRI in detecting them & analyse the functional outcomes & anterior laxity in patients with conservatively treated stable Ramp lesions(Group A) & unstable Ramp lesions (Group B) requiring repair.
Methodology
This was a prospective study including patients undergoing ACLR between November2019 to February2021. All MRI images were scanned for signs of Ramp lesion by a senior MSK radiologist. Systematic arthroscopic examination for Ramp was carried out & Repair was done when found unstable. Functional scores(IKDC, Lysholm & KOOS score) & anterior laxity using stress radiography were assessed postoperatively between Group A & Group B & compared to patients undergoing ACLR without Ramp lesions(Group C).
Results
31/347 patients had Ramp tears with a prevalence of 8.9% with more prevalence in acute(12.4%) than chronic(6.4%) ACL tears. The sensitivity of MRI in detecting these lesions was 51%. Functional scores & anterior laxity were comparable postoperatively between Group A & Group C, Group B & Group C respectively.
Conclusion
Our study concludes that Ramp tears have a prevalence of 8.9% with more prevalence in acute ACL tears. MRI has a limited role in diagnosing these lesions with a sensitivity of 52%. Conservatively treated Stable Ramp lesions & Repaired Unstable Ramp lesions have comparable outcomes and stability to knees without Ramp lesions.