Bae Bo Seung, Yoo Sunin, Lee Sang Hak
Department of Orthopedic Surgery, Kyung Hee University Hospital, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, 134-727, Seoul, Republic of Korea.
Knee Surg Relat Res. 2023 Aug 25;35(1):23. doi: 10.1186/s43019-023-00197-z.
Ramp lesions, commonly observed in patients with anterior cruciate ligament (ACL) injuries, have been previously defined as longitudinal tears around the meniscocapsular junction. However, the definitions and interpretations of ramp lesions have varied, emphasizing the need to confirm their presence before surgery and the importance of direct visualization using arthroscopy. Recent histological studies have reported new findings on ramp lesions, shedding light on their attachment mechanisms. The anatomical structures around the ramp lesion, such as the posterior horn of medial meniscus (PHMM), semimembranosus (SM), posteromedial (PM) capsule, and meniscotibial ligament (MTL), were assessed regarding how these structures could be attached to each other. The studies of ramp lesions have also contributed to the progression of biomechanical studies explaining the cause and effects of ramp lesions. Ramp lesion has been proven to stabilize the anteroposterior (AP) instability of ACL. In addition, various laboratory studies have demonstrated the relationship between rotational instability of the knee joint and ramp lesions. The analysis of risk factors of ramp lesion helped to understand the injury mechanism of the lesion. Many authors have evaluated the prevalence of ramp lesions in patients with ACL injuries. The development of arthroscopy techniques has influenced the outcomes of ACL reconstruction with the easy detection of ramp lesions. This review article aims to analyze the past findings and recent advancements in anatomical, biomechanical, and epidemiological studies of ramp lesions in patients who underwent ACL reconstruction, and provide various perspectives ramp lesions in patients with ACL reconstruction.
斜坡损伤常见于前交叉韧带（ACL）损伤患者，此前被定义为半月板-关节囊交界处的纵向撕裂。然而，斜坡损伤的定义和解释各不相同，这凸显了在手术前确认其存在的必要性以及使用关节镜直接可视化的重要性。最近的组织学研究报告了关于斜坡损伤的新发现，为其附着机制提供了新线索。对斜坡损伤周围的解剖结构，如内侧半月板后角（PHMM）、半膜肌（SM）、后内侧（PM）关节囊和半月板胫骨韧带（MTL），评估了这些结构如何相互附着。对斜坡损伤的研究也推动了生物力学研究的进展，解释了斜坡损伤的因果关系。斜坡损伤已被证明可稳定ACL的前后（AP）不稳定。此外，各种实验室研究已经证明了膝关节旋转不稳定与斜坡损伤之间的关系。对斜坡损伤危险因素的分析有助于了解该损伤的机制。许多作者评估了ACL损伤患者中斜坡损伤的发生率。关节镜技术的发展通过易于检测斜坡损伤而影响了ACL重建的结果。这篇综述文章旨在分析接受ACL重建患者斜坡损伤的解剖学、生物力学和流行病学研究的既往发现和最新进展，并提供关于ACL重建患者斜坡损伤的各种观点。
