Editorial Commentary: Many Ramp Lesions Appear to Heal Prior to Anterior Cruciate Ligament Reconstruction.

Abstract

Medial meniscus ramp lesions disrupt meniscocapsular and/or meniscotibial interconnections, exacerbating translational and rotational instability in the anterior cruciate ligament-deficient knee. The difficulty in directly visualizing this region of the meniscus has led some to advocate for routine viewing through the intercondylar notch and probing/debridement of the posterior horn through a posteromedial portal. A growing number of studies show that far more ramp lesions are seen on preoperative magnetic resonance imaging than are found at the time of arthroscopy, and clinical studies show equivalent clinical outcomes to repair when stable tears are left unrepaired. It seems likely that many ramp lesions heal and that stability of the tear dictates the need for intercondylar notch viewing and establishment of a posteromedial portal.