Medial Meniscal Ramp Tears in Patients With Anterior Cruciate Ligament Tears Undergoing Reconstruction: A Surgically Relevant Classification System Based on Tear Morphology.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] Conflict of interest statement: Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: S.T. reports a consulting relationship with Smith & Nephew. R.S. reports a consulting relationship with Smith & Nephew and Arthrex. C.M.L. reports that a family member has a consulting or advisory relationship with Smith & Nephew and Ossur Americas, receives funding grants from Smith & Nephew and Ossur Americas, and receives royalties from Ossur, Smith & Nephew, and Elsevier. In addition, C.M.L. receives educational support from Foundation Medical and Evolution Surgical. R.F.L. reports a consulting or advisory relationship with Smith & Nephew and Ossur Americas; receives funding grants from Smith & Nephew and Ossur Americas; and receives royalties from Ossur, Smith & Nephew, and Elsevier. All other authors (L.V.T., E.L.S.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 3. Arthroscopy. 2025 Aug;41(8):2955-2957. doi: 10.1016/j.arthro.2025.03.001. Epub 2025 Mar 7. Editorial Commentary: Anterior Cruciate Ligament Reconstruction Success Requires Additional Correction of Tibial Slope, Rotational Instability, and Meniscus Pathology: Meniscal Repair Failure Increases Knee Rotational Laxity. Bi AS(1), Chahla J(1). Author information: (1)Rush University Medical Center (J.C.). The anterior cruciate ligament (ACL) and medial and lateral menisci are essential contributors of both anteroposterior and rotational knee stability. Multiple studies have shown both ACL-deficient knees lead to increased risk of meniscal injury, as well as multiple types of meniscal tears or deficiency leading to increased risk of ACL tear or ACL reconstruction (ACLR) failures. All amenable meniscal tears, such as red-red peripheral tears, radial tears, root tears, lateral meniscal oblique radial tears, and ramp lesions should be attempted to be repaired at time of ACLR. In addition, other contributors to rotational stability, such as collateral, posterolateral/posteromedial corner, anterolateral injuries, and excessive posterior tibial slope should be identified and addressed. Rotational stability should be part of every ACL surgeon's algorithm; in my practice, my preference for patients who will place high rotational stress on their knee is for bone-patellar tendon-bone autograft ACLR, aggressively repairing aforementioned meniscal pathology, and adding anterolateral extraarticular reconstructions when recurvatum/ligamentous laxity, increased posterior tibial slope, high-risk patients (e.g., young female athletes in pivoting sports), or high-grade pivot shift is present. Copyright © 2025 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.arthro.2025.03.001