Because of this, it is less prone to tears than the medial meniscus. Disruption of the posterior horn of the medial meniscus. Clinical practice guidelines for the management of meniscal lesions. A ramp lesion consists of meniscosynovial or meniscocapsular tears, which can be difficult to diagnose arthroscopically from the anterior compartment. This video describes an arthroscopic approach to repair a ramp lesion of the medial meniscus. Detection at the time of arthroscopy can be accomplished based. The present guidelines on the management of meniscal lesions and isolated lesions. Lesions of the meniscus are commonly encountered in the practice of knee surgery.
Grade 2 intrasubstance lesion of the posterior horn of the medial meniscus. Classification and surgical repair of ramp lesions of the medial. Turek stone research foundation san francisco xxiv congress of the spanish. Tight medial compartment, measured as 4 mm, results in difficult arthroscopic probe examination of the phmm. The medial meniscus is injured much more often than the lateral menis cus, with the posterior horn being the most afflicted component. Any information contained in this pdf file is automatically generated from digital material submitted to.
Indications for meniscal repair may be distinguished in terms of associated lesions, and notably of knee ligament status and lesion morphology. Pdf meniscal ramp lesion repair by a transseptal portal. This disparity in motion contributes to the frequency in which each meniscus is injured. The medial meniscus is on the inner side and is attached to the tibia and the medial collateral ligament. Surgical management of degenerative meniscus lesions. The operation was performed under arthroscopy using a standard anterior. Logerstedt, pt, ma lynn snydermackler, pt, scd richard c.
A arthroscopic image of right knee viewing through the anterolateral portal. Purpose a degenerative meniscus lesion is a slowly developing process. Meniscal ramp lesions have been reported to be present in 9% to 17% of patients undergoing anterior cruciate ligament reconstruction. Both the false negatives were picked up by arthroscopy. Pdf medial and lateral knee joint menisci serve to transfer load and absorb shock, aid joint. The menisci are vital for the normal function and longterm health of the knee joint. A degenerative meniscus lesion is a slowly developing process typically involving a horizontal cleavage in a middleaged or older person. Management of intrasubstance horizontal cleavage meniscal lesions of microtraumatic origin remains poorly. B fenestration of the medial collateral ligament, proximal to the meniscus. The full text of this article is available in pdf format. T here is no direct muscular connection to the medial meniscus.
Ramp lesions, which are commonly associated with acl injuries and are often misdiagnosed, 1 disrupt the meniscotibial ligament and the posteromedial meniscus in the meniscocapsular zone. Diagnosis and treatment of ligamentous and meniscal. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus. Meniscal root tears can occur chronically in degenerative knees or following acute traumas. This article describes the diagnosis and treatment of ligamentous and meniscal injuries in the equine sti. Their aim is to encourage good practices in the meniscal lesion surgery. Meniscal ramp lesions are more frequently associated with anterior cruciate ligament acl injuries than previously recognized. The listed clinical practice recommendations are more conservative than traditional meniscus. Current concepts on posterior meniscal root lesion. Mr imagingbased diagnosis and classification of meniscal. Anechoic cystic lesion located adjacent to the meniscus. Meniscus, meniscal repair, longitudinal vertical tear, meniscocapsular lesion, ramp lesion. Arthroscopic repair of ramp lesion of medial meniscus vumedi.
Meniscal ramp lesions occur concomitantly with 9% to 19% of all acl tears. Insideout repair of meniscal ramp lesions arthroscopy. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. For tears of the clinical suspicion of tear of lateral meniscus was confirmed in 14 of the 16 arthrotomies, giving an accuracy of 87. Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Insideout repair of meniscal ramp lesions sciencedirect.
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