Batta Nafisa Shakir, Ksv Abhinetri, Rajani Heena, Samanta Riya
Department of Radiology, Mahajan Imaging, Sports Injury Centre, Safdarjung Hospital, Delhi, India.
Mahajan Imaging, Sports Injury Centre, Safdarjung Hospital, Delhi, India.
Indian J Radiol Imaging. 2025 Feb 13;35(3):494-503. doi: 10.1055/s-0044-1800805. eCollection 2025 Jul.
Ramp lesions or meniscocapsular separation are peripheral injuries that affect the posterior horn of the medial meniscus (PHMM) and the posteromedial capsule and are described as a tear or injury to the meniscocapsular junction or the meniscofemoral ligaments, particularly in the posteromedial aspect of the knee joint in the setting of pivot shift injuries. These almost always occur with a concomitant anterior cruciate ligament (ACL) tear. The meniscocapsular junction is the area where the peripheral attachment of the meniscus meets the joint capsule. In the context of ramp lesions, this region is susceptible to damage when there is an injury to the ACL. The medial meniscus serves as a firm attachment between the tibia and the femur, functioning as a stabilizer for the knee. It plays a crucial role in preventing anterior translation, particularly in knees with ACL deficiency, making it particularly prone to injuries. The ACL tear can cause the tibia to excessively translate anteriorly, leading to stress on the posterior aspect of the medial meniscus. Ramp lesions have significant biomechanical implications, and their occurrence is more prevalent than previously believed. Untreated ramp lesions may contribute to persistent knee symptoms, instability, and impaired function. These lesions are frequently underdiagnosed, leading to a lack of timely surgical intervention in standard knee arthroscopies. This limitation arises from the reliance on anterior portals, restricting a comprehensive evaluation of the posterior horn and attachment of the medial meniscus. Owing to its tendency to go unnoticed during magnetic resonance imaging interpretation and its "blind" spot in arthroscopic vision, achieving an accurate preoperative diagnosis is crucial. The objective of this article is to comprehensively present recent findings in the literature regarding meniscal ramp lesions, encompassing their anatomical, biomechanical, and diagnostic characteristics in an illustrative manner.
斜坡损伤或半月板-关节囊分离是影响内侧半月板后角（PHMM）和后内侧关节囊的周围损伤，被描述为半月板-关节囊交界处或半月板-股骨韧带的撕裂或损伤，特别是在膝关节后内侧，在轴移损伤的情况下。这些损伤几乎总是与前交叉韧带（ACL）撕裂同时发生。半月板-关节囊交界处是半月板的周边附着点与关节囊相遇的区域。在斜坡损伤的情况下，当ACL受伤时，该区域容易受到损伤。内侧半月板作为胫骨和股骨之间的牢固附着结构，起到膝关节稳定器的作用。它在防止胫骨前移方面起着关键作用，特别是在ACL缺失的膝关节中，这使得它特别容易受伤。ACL撕裂会导致胫骨过度向前移位，从而对内侧半月板的后部产生压力。斜坡损伤具有重要的生物力学意义，其发生率比以前认为的更高。未经治疗的斜坡损伤可能导致膝关节症状持续、不稳定和功能受损。这些损伤经常被漏诊，导致在标准膝关节关节镜检查中缺乏及时的手术干预。这种局限性源于依赖前外侧入路，限制了对内侧半月板后角及其附着点的全面评估。由于其在磁共振成像解读过程中容易被忽视，以及在关节镜视野中的“盲区”，实现准确的术前诊断至关重要。本文的目的是以说明性的方式全面介绍文献中关于半月板斜坡损伤的最新研究结果，包括其解剖学、生物力学和诊断特征。
