Rationale and Surgical Technique of Ramp Lesion Repair Through an Additional Posteromedial Portal

Background: Ramp lesions are longitudinal of the meniscocapsular complex posterior horn medial meniscus. These poorly recognized, difficult to diagnose, and require specific arthroscopic exploration. typically associated with anterior cruciate ligament rupture have important biomechanical consequences as they result in increased tibial translation external rotation. Suture hook repair through posteromedial portal is safe provides a high healing rate. Indications: Spontaneous ramp rarely observed, indicated for all involvement meniscotibial ligament. The choice technique vertical suture performed under visual control allows restoration continuity effective these lesions. Technique Description: Standardized exploration systematic visualization compartment using transnotch crucial point diagnose use transillumination needle palpate lesion tip case doubt (hidden lesion) before performing safely. By vision by introducing instruments portal, debridement shaver control. Vertical taking care pass perforating deep face capsular portion lesion. Similarly, it recommended not catch too much meniscal tissue on margin side remain red zone perforate meniscus avascular avoid secondary caused “cheese wire” effect sutures white zone. Results: This has allowed us reduce our percentage meniscectomy after from 25% standard 11.3% at 4 years follow-up. Discussion/Conclusion: Systematic management lesions, which demonstrate serious mechanical clinical consequences.