Magnetic Resonance Imaging Evaluation of Meniscal Ramp Lesions and their Association with Anterior Cruciate Ligament Injury Severity: A Retrospective Observational Study.
TL;DR
The strong association with ACL injury and having a potentially important role in knee stabilisation, their injuries need to be given due importance by radiologists and should not be underreported.
Abstract
Background
Meniscal ramp lesions are frequently associated with anterior cruciate ligament (ACL) injuries and are often overlooked on magnetic resonance imaging (MRI). Their relationship with the severity of ACL injury remains incompletely understood.
Objective
The purpose of this study is to determine the association of meniscal rupture of the posterior meniscocapsular attachment (RAMP) lesions in anterior cruciate ligament (ACL) injury and evaluate the different grades of RAMP lesions with the severity of ACL tear. SUBJECTS AND
Methods
This retrospective study included 252 patients who underwent magnetic resonance imaging (MRI) knee examination with a history of trauma to the knee while playing sports between April 2024 and April 2025. The two experienced radiologists reviewed the MRI examinations of these patients and reached a consensus regarding various MRI findings of different grades of ACL tears and their association with RAMP lesions. The Cohen's kappa (k) and Fisher's exact test statistics were used.
Results
Out of 252 patients with a sports injury to the knee and clinical suspicion of an acute ACL injury, 109 (43.3%) had an ACL injury and 27 had a RAMP lesion, with a prevalence of 10.7%. The RAMP lesion was seen only in patients with ACL injury and higher grades of ACL injury, i.e., Grade 2 and 3 were associated with RAMP lesion 11 (40.7%) and 10 (37.0%), respectively, although statistically not significant ( P = 0.291).
Conclusion
Out of 252 patients with sports-related injuries to the knee with clinical suspicion of ACL injury, only 43.3% had ACL injuries and RAMP lesions have a prevalence of 10.7% (27) of all the patients with acute ACL injury. The strong association with ACL injury and having a potentially important role in knee stabilisation, their injuries need to be given due importance by radiologists and should not be underreported.