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The Hidden Lesion of the Knee: Risk Factors Study

The Hidden Lesion of the Knee: Risk Factors Study

Mohamed Amine Gharbi , MD, TUNISIA Anis Tebourbi, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Rami Triki, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA

Mongi Slim Marsa University Hospital Center, Tunis, Tunis, TUNISIA


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

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Diagnosis / Condition

Treatment / Technique

Patient Populations

Diagnosis Method

MRI


Summary: Meniscal ramp lesion has diagnostic particularities and should not be missed. Faced with the risk of ACL ligamentoplasty failure if the ramp is not repaired, a codified protocol and recommendations are necessary.


Background

Meniscal ramp lesions (MRL), once considered rare, are associated with anterior cruciate ligament rupture (ACL). Arthroscopic surgery has led to the discovery of an increasing number of MRL that are not diagnosed preoperatively.

Objective

The aim of our work was to study the frequency and risk factors of meniscal ramp lesions.

Methods

We studied retrospectively the last 100 patients operated for ACL rupture between 2019 and 2020. We looked for factors involved in the genesis of these lesions. MRI sensitivity, specificity, reliability and predictive values were calculated. Lesional associations were sought.

Results

The frequency of MRL was 25%. This injury was more frequent in male (85%) sportsmen (69%) under 30 years old (61%) and the trauma causing this type of injury was a sports accident (76%), of the leaning type (84%) affecting the dominant side (88%). The only parameter with a statistically significant result was the duration of the trauma. In our work MRI had a sensitivity of 72%, specificity of 75%, negative predictive value of 89% and positive predictive value of 49%. Based on these results, the reliability of MRI was 74%. Arthroscopic surgery is considered as the "gold standard" in the diagnosis of these lesions but the classical approaches remain insufficient to fully explore and repair MRL.

Conclusion

Meniscal ramp lesion has diagnostic particularities: MRI imaging has insufficient detection and with arthroscopic surgery lesions may go unnoticed. Faced with the risk of ACL ligamentoplasty failure if the ramp is not repaired, a codified protocol and recommendations are necessary.


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