All-inside ramp lesion repair via anterior portals and pie-crusting: Excellent outcomes and survivorship at one-year follow-up

IF 1.5 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2025-03-18 DOI:10.1016/j.jor.2025.03.014

Antonio Clemente , Domenico Zaccari , Federico Verdone , Glauco Loddo , Francesco Bosco , Francesco Saccia

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引用次数: 0

Abstract

Background

Ramp lesions, located in the posterior horn of the medial meniscus, are commonly associated with anterior cruciate ligament (ACL) injuries and contribute to knee instability if untreated. Traditional repair methods use posteromedial portals, but newer approaches, such as the all-inside technique through anterior arthroscopic portals with pie-crusting of the posterior oblique ligament (POL), offer improved access and reduced morbidity. This study aimed to assess the clinical outcomes, return-to-sport rates, and failure rates of this technique compared to established methods.

Materials and methods

A retrospective analysis included 54 patients (mean age: 29.1 years) who underwent ramp lesion repair using the all-inside technique between January 2019 and December 2022. Clinical outcomes were evaluated with the IKDC score, Lysholm score, and Tegner activity scale. Failure was defined as the need for revision surgery.

Results

At a mean follow-up of 30.7 months, patients had a mean IKDC score of 81.5 ± 7.1 and Lysholm score of 94.5 ± 7.4. The Tegner activity scale declined slightly from 7.2 ± 1.2 preoperatively to 6.8 ± 1.3 postoperatively. All patients returned to sport within 9.2 ± 2.5 months, with a failure rate of 12.9 % and an average revision time of 13.1 ± 8.2 months.

Conclusion

The all-inside technique for ramp lesion repair via anterior portals provides excellent clinical outcomes and return-to-sport rates, with failure rates comparable to other methods. This minimally invasive approach offers improved access, reduced morbidity, and a reliable option for managing ramp lesions in ACL-injured patients.

Level of evidence

IV.

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来源期刊

Journal of orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.