Risk factors and prevalence of ramp lesions in ACL ruptures: An analysis from the registry of the Francophone Arthroscopic Society

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 32; no. 7; pp. 1700 - 1709
• Main Authors: Lambrey, Pierre‐Jean, Fayard, Jean‐Marie, Graveleau, Nicolas, Toanen, Cécile, Noailles, Thibaut, Letartre, Romain, Barth, Johannes, Cavaignac, Etienne, Morvan, Antoine, Gerometta, Antoine, Hardy, Alexandre, Geffroy, Loic, Kajetanek, Charles, Rousseau, Thomas, Phillippeau, Jean Marie, Aubret, Sylvain, Guillou, Ronan, Ballas, Richard, Tostain, Olivier, Laboute, Eric, Lutz, Christian, Pineau, Vincent, Gunepin, Francois Xavier, Freychet, Benjamin, Bouguennec, Nicolas, Thaunat, Mathieu
• Format: Journal Article
• Language: English
• Published: Germany 01.07.2024
• Subjects: ACL; ACLR; Adult; Age Factors; Anterior Cruciate Ligament Injuries - epidemiology; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction; Arthroscopy; Female; Humans; Joint Instability - epidemiology; Joint Instability - etiology; Male; Medial Collateral Ligament, Knee - injuries; Medial Collateral Ligament, Knee - surgery; medial meniscus; Middle Aged; Prevalence; ramp; Registries; remnant; Reoperation - statistics & numerical data; Retrospective Studies; Risk Factors; Sex Factors; Societies, Medical; Tibial Meniscus Injuries - epidemiology; Tibial Meniscus Injuries - surgery; Young Adult; remnant; medial meniscus; ACL; ACLR; ramp
• ISSN: 0942-2056; 1433-7347; 1433-7347
• DOI: 10.1002/ksa.12194

Purpose The study aimed to estimate the prevalence of ramp lesions among patients undergoing anterior cruciate ligament (ACL) reconstruction and identify risk factors associated with these lesions. Methods A retrospective, multicentre cohort study was conducted using data from the Francophone Arthroscopic Society's registry, including 5359 patients who underwent ACL reconstruction (ACLR) from June 2020 to June 2023. Potential risk factors for ramp lesion such as patient demographics, revision surgery, pivot shift, side‐to‐side anteroposterior laxity, medial collateral ligament (MCL) injury, lateral meniscal tear and the volume of ligament remnant were evaluated using multivariate regression analyses. BMI and delay to surgery were also assessed. Results Ramp lesions were identified in 822 patients (15.3%). Univariate analysis identified male sex, younger age, revision surgery, lateral meniscal injury, percentage of ACL remnant (all p < 0.0001) and pivot shift (p = 0.0103) as significant risk factors. MCL injury was associated with a lower risk (p < 0.0001). In multivariate analysis, male sex, younger age, revision surgery, lateral meniscal injury and percentage of ACL remnants remained significant risk factors, while MCL injury remained a protective factor. The anteroposterior laxity wasn't a significant predictor in either analysis. In subgroup analysis, there were no differences concerning body mass index (n.s) and the delay to surgery (n.s). Conclusion The study identified male sex, younger age, revision surgery, lateral meniscal injury and pourcentage of ACL remnant as significant risk factors for ramp lesions, with MCL injury acting as a protective factor. This will help regarding the suspicion and identification of ramp lesions. Level of Evidence Level III.