Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears.
Background: Ramp lesions correspond to posterior meniscocapsular tears of the medial meniscus and are common with anterior cruciate ligament (ACL) tears. They cannot be recognized easily on preoperative magnetic resonance imaging (MRI) scans and are difficult to visualize even using standard arthro...
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| Format: | Article |
| Language: | English |
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Albanian Society for Trauma and Emergency Surgery
2023-07-01
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| Series: | Albanian Journal of Trauma and Emergency Surgery |
| Subjects: | |
| Online Access: | https://journal.astes.org.al/index.php/AJTES/article/view/332 |
| _version_ | 1797778444690391040 |
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| author | Neritan Borici Ekene Ezeokoli Nathaniel Gray Loyd Scott McKay |
| author_facet | Neritan Borici Ekene Ezeokoli Nathaniel Gray Loyd Scott McKay |
| author_sort | Neritan Borici |
| collection | DOAJ |
| description |
Background: Ramp lesions correspond to posterior meniscocapsular tears of the medial meniscus and are common with anterior cruciate ligament (ACL) tears. They cannot be recognized easily on preoperative magnetic resonance imaging (MRI) scans and are difficult to visualize even using standard arthroscopic approaches. We aim to (1) characterize and evaluate the prevalence of ramp lesions in pediatric patients at a major tertiary children's hospital, providing important insights into demographics, diagnosis, treatment, and functional disability and (2) evaluate the efficacy of MRI in its diagnosis.
Materials and Methods: We retrospectively reviewed patients under 21 years old undergoing posterior medial meniscal injuries and anterior cruciate ligament ruptures with arthroscopic examination and positive ramp lesions from 2018 to 2021. Patient demographics (including gender and age), initial presentation, physical examination findings, mechanism of injury, pre-operative radiologic findings, and treatment were collected and reviewed via electronic medical record. Exclusion criteria included patients over 18 years old, patients, that did not have an MRI, and patients that were not treated surgically.
Results: There were 117 patients that met the inclusion criteria out of 690 patients. The mean age at diagnosis was 15.6±1.6 years and the mean BMI was 26.7±6.4. 83% of injuries occurred secondary to sporting activities. Ramp lesions were only detected on preoperative MRI in 63% of cases, suspected in 3%, and not detected in 33%. The sensitivity of the MRI was 63%.
Conclusions: Ramp lesions were found in 117/690 (16.9%) of patients undergoing ACL reconstruction. MRI had a low sensitivity rate of 63%. During ACL reconstruction, a careful review of the posteromedial compartment is important to recognize less obvious trauma. Lack of treatment may lead to continued instability and risk of complications in these patients.
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| first_indexed | 2024-03-12T23:17:27Z |
| format | Article |
| id | doaj.art-7aa9a75a7ba34e86925926259b20820f |
| institution | Directory Open Access Journal |
| issn | 2521-8778 2616-4922 |
| language | English |
| last_indexed | 2024-03-12T23:17:27Z |
| publishDate | 2023-07-01 |
| publisher | Albanian Society for Trauma and Emergency Surgery |
| record_format | Article |
| series | Albanian Journal of Trauma and Emergency Surgery |
| spelling | doaj.art-7aa9a75a7ba34e86925926259b20820f2023-07-16T23:51:02ZengAlbanian Society for Trauma and Emergency SurgeryAlbanian Journal of Trauma and Emergency Surgery2521-87782616-49222023-07-017210.32391/ajtes.v7i2.332Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears.Neritan Borici0Ekene Ezeokoli1Nathaniel Gray Loyd2Scott McKay3Baylor College of Medicine, Department of Surgery, Orthopedics Houston, TX 77030,Texas Children's Hospital, Surgery, Orthopedics, Texas,Baylor College of MedicineTexas Children's Hospital, Surgery, Orthopedics, Texas, Background: Ramp lesions correspond to posterior meniscocapsular tears of the medial meniscus and are common with anterior cruciate ligament (ACL) tears. They cannot be recognized easily on preoperative magnetic resonance imaging (MRI) scans and are difficult to visualize even using standard arthroscopic approaches. We aim to (1) characterize and evaluate the prevalence of ramp lesions in pediatric patients at a major tertiary children's hospital, providing important insights into demographics, diagnosis, treatment, and functional disability and (2) evaluate the efficacy of MRI in its diagnosis. Materials and Methods: We retrospectively reviewed patients under 21 years old undergoing posterior medial meniscal injuries and anterior cruciate ligament ruptures with arthroscopic examination and positive ramp lesions from 2018 to 2021. Patient demographics (including gender and age), initial presentation, physical examination findings, mechanism of injury, pre-operative radiologic findings, and treatment were collected and reviewed via electronic medical record. Exclusion criteria included patients over 18 years old, patients, that did not have an MRI, and patients that were not treated surgically. Results: There were 117 patients that met the inclusion criteria out of 690 patients. The mean age at diagnosis was 15.6±1.6 years and the mean BMI was 26.7±6.4. 83% of injuries occurred secondary to sporting activities. Ramp lesions were only detected on preoperative MRI in 63% of cases, suspected in 3%, and not detected in 33%. The sensitivity of the MRI was 63%. Conclusions: Ramp lesions were found in 117/690 (16.9%) of patients undergoing ACL reconstruction. MRI had a low sensitivity rate of 63%. During ACL reconstruction, a careful review of the posteromedial compartment is important to recognize less obvious trauma. Lack of treatment may lead to continued instability and risk of complications in these patients. https://journal.astes.org.al/index.php/AJTES/article/view/332ACLMRImeniscusreconstruction |
| spellingShingle | Neritan Borici Ekene Ezeokoli Nathaniel Gray Loyd Scott McKay Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears. Albanian Journal of Trauma and Emergency Surgery ACL MRI meniscus reconstruction |
| title | Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears. |
| title_full | Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears. |
| title_fullStr | Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears. |
| title_full_unstemmed | Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears. |
| title_short | Characterization and Prevalence of Pediatric Ramp Lesions Associated with Anterior Cruciate Ligament Tears. |
| title_sort | characterization and prevalence of pediatric ramp lesions associated with anterior cruciate ligament tears |
| topic | ACL MRI meniscus reconstruction |
| url | https://journal.astes.org.al/index.php/AJTES/article/view/332 |
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