PMID- 32674943
OWN - NLM
STAT- MEDLINE
DCOM- 20210429
LR  - 20210429
IS  - 1526-3231 (Electronic)
IS  - 0749-8063 (Linking)
VI  - 36
IP  - 11
DP  - 2020 Nov
TI  - Examining Techniques for Treatment of Medial Meniscal Ramp Lesions During 
      Anterior Cruciate Ligament Reconstruction: A Systematic Review.
PG  - 2921-2933
LID - S0749-8063(20)30474-6 [pii]
LID - 10.1016/j.arthro.2020.05.041 [doi]
AB  - PURPOSE: The purpose of this study was to systematically review the clinical 
      outcomes and adverse events among different techniques for treatment of medial 
      meniscal ramp lesions performed in conjunction with anterior cruciate ligament 
      (ACL) reconstruction. METHODS: A systematic review was performed using the 
      Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 
      guidelines. PubMed, Cochrane Reviews, Web of Science, and Medline databases were 
      searched for studies examining clinical outcomes after surgical treatment of ramp 
      lesions. Studies were selected if they met the following criteria: (1) evaluation 
      of the outcome of surgical repair of meniscal ramp lesions, (2) injuries 
      associated with ACL tears, (3) minimum 6-month follow up, (4) publication in a 
      peer-reviewed journal, and (5) English language or translation readily available. 
      RESULTS: Seven studies met inclusion criteria (485 patients; mean age 27.1 years 
      [range 12 to 59]; mean follow-up 26.9 months [range 8 to 40]). Two all-inside 
      techniques (suture-hook and an all-inside meniscus repair device) in addition to 
      abrasion and trephination alone were analyzed. Each technique demonstrated 
      significant increases in postoperative Lysholm and International Knee 
      Documentation Committee (IKDC) scores, reaching the established minimal 
      clinically important difference (MCID) for each patient reported outcome. 
      Incomplete healing was documented in 12.1% to 12.9% of cases in which the tear 
      was not repaired at the time of ACL reconstruction, 2.3% to 11.7% in cases using 
      the suture-hook for repair, and 10.8% to 15% in the all-inside meniscus repair 
      device group. CONCLUSION: This systematic review demonstrated that several 
      approaches used to treat medial meniscal ramp lesions associated with ACL tears 
      lead to positive clinical outcomes. Small, stable tears <2 cm in size may be 
      managed with debridement alone. For larger, more unstable lesions, an all-inside 
      approach has demonstrated positive clinical outcomes. Prospective trials are 
      needed to determine the best management for meniscal ramp lesions. Additionally, 
      further research is needed to better understand how to minimize the risk of 
      technique-related complications (e.g., improper implant deployment). LEVEL OF 
      EVIDENCE: Level IV, systematic review of level II, III, and IV studies.
CI  - Copyright (c) 2020 Arthroscopy Association of North America. Published by Elsevier 
      Inc. All rights reserved.
FAU - Acosta, Jonathan
AU  - Acosta J
AD  - Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, 
      Pennsylvania, U.S.A.
FAU - Ravaei, Sean
AU  - Ravaei S
AD  - Department of Orthopaedic Surgery, Tulane University School of Medicine, New 
      Orleans, Louisiana, U.S.A.
FAU - Brown, Symone M
AU  - Brown SM
AD  - Department of Orthopaedic Surgery, Tulane University School of Medicine, New 
      Orleans, Louisiana, U.S.A.
FAU - Mulcahey, Mary K
AU  - Mulcahey MK
AD  - Department of Orthopaedic Surgery, Tulane University School of Medicine, New 
      Orleans, Louisiana, U.S.A.. Electronic address: mary.mulcahey.md@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
DEP - 20200714
PL  - United States
TA  - Arthroscopy
JT  - Arthroscopy : the journal of arthroscopic & related surgery : official 
      publication of the Arthroscopy Association of North America and the International 
      Arthroscopy Association
JID - 8506498
SB  - IM
CIN - Arthroscopy. 2020 Nov;36(11):2934-2937. PMID: 33172589
MH  - Adolescent
MH  - Adult
MH  - Anterior Cruciate Ligament Injuries/surgery
MH  - Anterior Cruciate Ligament Reconstruction/*methods
MH  - Arthroscopy/*methods
MH  - Child
MH  - Female
MH  - Humans
MH  - Knee/surgery
MH  - Knee Joint/surgery
MH  - Male
MH  - Menisci, Tibial/*surgery
MH  - Middle Aged
MH  - Sutures
MH  - Young Adult
EDAT- 2020/07/18 06:00
MHDA- 2021/04/30 06:00
CRDT- 2020/07/18 06:00
PHST- 2019/12/05 00:00 [received]
PHST- 2020/05/19 00:00 [revised]
PHST- 2020/05/21 00:00 [accepted]
PHST- 2020/07/18 06:00 [pubmed]
PHST- 2021/04/30 06:00 [medline]
PHST- 2020/07/18 06:00 [entrez]
AID - S0749-8063(20)30474-6 [pii]
AID - 10.1016/j.arthro.2020.05.041 [doi]
PST - ppublish
SO  - Arthroscopy. 2020 Nov;36(11):2921-2933. doi: 10.1016/j.arthro.2020.05.041. Epub 
      2020 Jul 14.