Medical Disclaimer
The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.
🚨Emergency? If you have severe symptoms, difficulty breathing, or think it's an emergency, call 000 immediately.
Ramp Lesions (Hidden Meniscus Tears with ACL Injuries)
Meniscal ramp lesions are tears between the back of the medial meniscus (inner knee cartilage cushion) and the joint capsule - they occur in 40-60% of ACL (anterior cruciate ligament) tears but are often missed on MRI and even during knee arthroscopy if not specifically looked for - ramp lesions cause persistent knee pain, swelling, and giving way similar to ACL instability - they should be repaired during ACL reconstruction surgery using sutures to reattach the meniscus to the capsule, achieving 85-90% healing and preventing later meniscus degeneration.
📖What is Ramp Lesions (Hidden Meniscus Tears with ACL Injuries)?
Meniscal ramp lesions are tears between the back of the medial meniscus (inner knee cartilage cushion) and the joint capsule - they occur in 40-60% of ACL (anterior cruciate ligament) tears but are often missed on MRI and even during knee arthroscopy if not specifically looked for - ramp lesions cause persistent knee pain, swelling, and giving way similar to ACL instability - they should be repaired during ACL reconstruction surgery using sutures to reattach the meniscus to the capsule, achieving 85-90% healing and preventing later meniscus degeneration.
🔬What Causes It?
- ACL tear causing abnormal posterior tibial translation (shin bone sliding backward) stressing posterior meniscus attachment
- Pivoting injury (same mechanism as ACL tear) tearing meniscocapsular junction
- Hyperflexion injury (extreme knee bending) pulling meniscus away from capsule
- Meniscal rim avulsion from forceful rotation on planted foot
- Chronic ACL deficiency causing repetitive posterior instability damaging meniscus
⚠️Risk Factors
You may be at higher risk if:
- ACL tear (40-60% of ACL tears have associated ramp lesions)
- Sports with pivoting, cutting, jumping (basketball, soccer, skiing, football)
- Delayed ACL reconstruction (chronic ACL deficiency increases ramp lesion prevalence)
- High-grade pivot shift (severe rotational instability increases ramp lesion likelihood)
- Male gender (slightly higher prevalence in males with ACL tears)
🛡️Prevention
- ✓Prevent ACL tears with neuromuscular training (reduces ACL injury risk, secondarily reduces ramp lesions)
- ✓Early ACL reconstruction if torn (delayed surgery increases ramp lesion prevalence)
- ✓Insist on thorough arthroscopic examination during ACL surgery (surgeon must specifically look for ramp lesions)
- ✓Address all meniscal pathology during ACL reconstruction (don't leave ramp lesions untreated)
- ✓Strengthen hamstrings and quadriceps preventing knee instability