Ramp Lesions: An Unrecognized Posteromedial Instability?

Clin Sports Med. 2020 Jan;39(1):69-81. doi: 10.1016/j.csm.2019.08.010.


Meniscal ramp lesions occur much more frequently than was previously considered, and particularly so in ACL-injured knees. The historically high rate of missed diagnoses is a result of unfamiliarity with this injury pattern within the orthopedic community, and also the difficulty in diagnosis. A systematic exploration of the posteromedial compartment of the knee is mandatory to reliably identify ramp lesions. Failure to recognize and repair these injuries is associated with persistent anterior and posteromedial instability. Understanding their nature, biomechanics, and epidemiology is essential in allowing orthopedic surgeons to suspect their presence and adequately treat these lesions.

Keywords: Hidden lesion; Meniscal instability; Meniscal tear; Meniscocapsular tear; Meniscotibial ligament; Meniscus; Posteromedial corner; Ramp lesion.

Publication types

  • Review

MeSH terms

  • Arthroscopy
  • Humans
  • Joint Instability / physiopathology*
  • Joint Instability / surgery
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiopathology*
  • Knee Joint / surgery
  • Magnetic Resonance Imaging
  • Postoperative Care
  • Suture Techniques
  • Tibial Meniscus Injuries / classification
  • Tibial Meniscus Injuries / diagnosis
  • Tibial Meniscus Injuries / physiopathology
  • Tibial Meniscus Injuries / surgery*