Ramp lesions associated with ACL injuries are more likely to be present in contact injuries and complete ACL tears

Abstract

The purpose of this study was to analyse patient and injury characteristics as well as arthroscopic findings in a prospective cohort of ACL-injured patients with or without an associated ramp lesion. Two hundred and twenty-four patients undergoing a primary (n=196) or revision (n=28) ACL reconstruction were included. The presence of a ramp lesion was determined by a systematic arthroscopic inspection of the posteromedial compartment. Chi-square tests were used to compare the population of ACL-injured patients with and without a ramp lesion regarding sex, age, body mass index, previous ACL injuries, sport before injury, and injury characteristics. Significance was set at p<0.05. Fifty-three out of 224 patients had a ramp lesion (24%). The presence of the latter was not related to any of the analysed patient characteristics. The prevalence of the lesion was higher in contact injuries (n=19; 41%) compared with non-contact injures (n=34; 19%; p<0.001). It was higher in patients with complete ACL ruptures (n=49; 27%) as opposed to partial ruptures (n=1; 4%; p=0.01). A patient was 2.98 [95% CI 1.49-5.98] times more likely to have a ramp lesion if the ACL injury was declared to have been caused by direct contact and 8.71 [95% CI 1.15-66.12] times more likely if the ACL tear was complete. Ramp lesions may be anticipated in almost one out of four patients undergoing ACL reconstruction, especially if a patient sustained a contact injury and in the presence of a complete ACL tear. III.