Ramp lesions associated with ACL injuries are more likely to be present in contact injuries and complete ACL tears

Romain Seil*, Caroline Mouton, Julien Coquay, Alexander Hoffmann, Christian Nührenbörger, Dietrich Pape, Daniel Theisen

*Corresponding author for this work

    Research output: Contribution to journalArticleResearchpeer-review

    53 Citations (Scopus)


    Purpose: The purpose of this study was to analyse patient and injury characteristics as well as arthroscopic findings in a prospective cohort of ACL-injured patients with or without an associated ramp lesion. Methods: Two hundred and twenty-four patients undergoing a primary (n = 196) or revision (n = 28) ACL reconstruction were included. The presence of a ramp lesion was determined by a systematic arthroscopic inspection of the posteromedial compartment. Chi-square tests were used to compare the population of ACL-injured patients with and without a ramp lesion regarding sex, age, body mass index, previous ACL injuries, sport before injury, and injury characteristics. Significance was set at p < 0.05. Results: Fifty-three out of 224 patients had a ramp lesion (24%). The presence of the latter was not related to any of the analysed patient characteristics. The prevalence of the lesion was higher in contact injuries (n = 19; 41%) compared with non-contact injures (n = 34; 19%; p < 0.001). It was higher in patients with complete ACL ruptures (n = 49; 27%) as opposed to partial ruptures (n = 1; 4%; p = 0.01). A patient was 2.98 [95% CI 1.49–5.98] times more likely to have a ramp lesion if the ACL injury was declared to have been caused by direct contact and 8.71 [95% CI 1.15–66.12] times more likely if the ACL tear was complete. Conclusion: Ramp lesions may be anticipated in almost one out of four patients undergoing ACL reconstruction, especially if a patient sustained a contact injury and in the presence of a complete ACL tear. Level of evidence: III.

    Original languageEnglish
    Pages (from-to)1080-1085
    Number of pages6
    JournalKnee Surgery, Sports Traumatology, Arthroscopy
    Issue number4
    Publication statusPublished - 1 Apr 2018


    • Anterior cruciate ligament
    • Epidemiology
    • Knee
    • Ramp lesion


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