Kaiser Joshua T, Meeker Zachary D, Horner Nolan S, Sivasundaram Lakshmanan, Wagner Kyle R, Mazra Armaan F, Cole Brian J
Midwest Orthopaedics at Rush University Medical Center, Chicago, IL, USA.
J Orthop. 2022 May 9;32:31-35. doi: 10.1016/j.jor.2022.05.001. eCollection 2022 Jul-Aug.
Meniscal ramp lesions are injuries of the posterior horn of the medial meniscus at the meniscocapsular junction or the meniscotibial ligament and are frequently associated with concomitant anterior cruciate ligament (ACL) injury.
To review the current literature on meniscal ramp lesion management to better define the indications for and outcomes of repair.
A narrative literature review was performed using PubMed, Embase, and Scopus databases. Studies of all evidence levels (I-V) pertaining to meniscal ramp lesions were reviewed and included.
The incidence of ramp lesions has been reported between 16% and 42%. Arthroscopy remains the diagnostic gold standard as magnetic resonance imaging has limited sensitivity. Biomechanically, ramp lesions are known to increase anterior tibial translation and rotational laxity. Clinical investigations regarding optimal management are largely limited to studies of low evidence levels. While case series have demonstrated that repair is safe and efficacious, comparative studies have failed to suggest that repair of stable lesions results in superior outcomes when compared to conservative treatment approaches. However, repair may be warranted in unstable ramp lesion injuries despite the increased risk for revision surgery.
While there is evidence to suggest that ramp lesion repair can restore joint kinematics, the current body of clinical literature fails to suggest that outcomes following repair are superior to injuries managed conservatively. The current body of clinical literature is limited, and further robust, long-term study is warranted to better guide injury diagnosis and management protocol.
半月板斜坡损伤是指内侧半月板后角在半月板-关节囊交界处或半月板-胫骨韧带处的损伤，常与前交叉韧带（ACL）损伤同时存在。
回顾目前关于半月板斜坡损伤治疗的文献，以更好地明确修复的适应证和结果。
使用PubMed、Embase和Scopus数据库进行叙述性文献综述。对所有证据水平（I-V）的与半月板斜坡损伤相关的研究进行了综述并纳入。
斜坡损伤的发生率据报道在16%至42%之间。关节镜检查仍然是诊断的金标准，因为磁共振成像的敏感性有限。从生物力学角度来看，已知斜坡损伤会增加胫骨前移和旋转松弛度。关于最佳治疗方法的临床研究在很大程度上限于低证据水平的研究。虽然病例系列研究表明修复是安全有效的，但比较研究未能表明与保守治疗方法相比，稳定损伤的修复能带来更好的结果。然而，对于不稳定的斜坡损伤，尽管翻修手术风险增加，但修复可能是必要的。
虽然有证据表明斜坡损伤修复可以恢复关节运动学，但目前的临床文献未能表明修复后的结果优于保守治疗的损伤。目前的临床文献有限，需要进一步进行有力的长期研究，以更好地指导损伤诊断和治疗方案。
