ArticleArthroscopy, sports medicine, and rehabilitation2025
Surgical Delay Increases the Incidence of Ramp Lesions and Bucket-Handle Tears in Anterior Cruciate Ligament Injuries.
Article in Arthroscopy, sports medicine, and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To investigate the correlation between surgical delay and the incidence of ramp lesions by performing meticulous arthroscopic evaluation of the posterior compartment in patients undergoing anterior cruciate ligament (ACL) reconstruction. Methods: This retrospective cohort study included patients who underwent primary ACL reconstruction between July 2015 and January 2023. To minimize underdiagnosis of ramp lesions, all patients received comprehensive arthroscopic evaluation of the posterior compartment via intercondylar notch view and posteromedial or posterolateral portals. Meniscal tears were classified on the basis of Cooper's system, and radial and longitudinal tear components were analyzed separately. Patients were categorized into 3 groups according to time from injury to surgery: group 1 (<6 weeks), group 2 (6 weeks-6 months), and group 3 (>6 months). Incidence and tear patterns were compared among groups. Results: A total of 201 patients were included in the study. The overall incidence of meniscal tears was lowest in group 2 (50%) compared with group 1 (73%; Conclusions: A surgical delay of more than 6 months was associated with a higher incidence of medial ramp lesions, which can progress to bucket-handle tears in ACL-deficient knees. Early surgical intervention should be considered in ACL ruptures accompanied by rotational instability to prevent progression of medial meniscal pathology. Level of Evidence: Level III, retrospective cohort study.
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