Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tears

Abstract Background Few studies have investigated the relationship between the chronicity of anterior cruciate ligament (ACL) tears and the incidence of ramp lesion subtypes. The purpose of this study was to evaluate the relationship between the chronicity of ACL tears and the new subtypes of ramp l...

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Main Authors: Sang-Hoon Roh, Sung-Sahn Lee, Dae-Hee Lee
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Journal of Orthopaedics and Traumatology
Subjects:
Online Access:https://doi.org/10.1186/s10195-025-00864-9
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author Sang-Hoon Roh
Sung-Sahn Lee
Dae-Hee Lee
author_facet Sang-Hoon Roh
Sung-Sahn Lee
Dae-Hee Lee
author_sort Sang-Hoon Roh
collection DOAJ
description Abstract Background Few studies have investigated the relationship between the chronicity of anterior cruciate ligament (ACL) tears and the incidence of ramp lesion subtypes. The purpose of this study was to evaluate the relationship between the chronicity of ACL tears and the new subtypes of ramp lesions for treatment selection. Methods Between May 2015 and April 2023, 367 patients who underwent primary ACL reconstruction were evaluated. Meniscal repair was performed in cases where a ramp lesion was identified. According to the exclusion criteria, 96 patients who underwent repair of ramp lesion were divided into three groups (PR type: pure ramp lesion, RR type: red–red ramp lesion, and DL type: double longitudinal ramp lesion), and the groups were compared for chronicity of ACL tears and time from injury (TFI). Results Of the 30 patients classified as having PR type lesions, 11 (36.7%) had chronic ACL tears. Likewise, of the 37 patients classified as having RR type lesions, 14 (37.8%) had chronic ACL tears. In contrast, among the 29 patients classified as having DL type lesions, 20 (69.0%) had chronic ACL tears, indicating a statistically significant difference (p < 0.05). This distinction was significant up to 12 months after injury. Conclusions Pure ramp lesions accounted for only 31% of all ramp lesions in ACL tears. In addition, chronic ACL tears are more frequently accompanied by double longitudinal tears than by red–red zone longitudinal tears or pure ramp lesions of the meniscus posterior horn. Study Design: case series, level of evidence IV.
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spelling doaj-art-07eb48eb32fe403882f85f90d1ee83d42025-08-20T03:03:45ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992025-07-0126111410.1186/s10195-025-00864-9Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tearsSang-Hoon Roh0Sung-Sahn Lee1Dae-Hee Lee2Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University School of MedicineDepartment of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background Few studies have investigated the relationship between the chronicity of anterior cruciate ligament (ACL) tears and the incidence of ramp lesion subtypes. The purpose of this study was to evaluate the relationship between the chronicity of ACL tears and the new subtypes of ramp lesions for treatment selection. Methods Between May 2015 and April 2023, 367 patients who underwent primary ACL reconstruction were evaluated. Meniscal repair was performed in cases where a ramp lesion was identified. According to the exclusion criteria, 96 patients who underwent repair of ramp lesion were divided into three groups (PR type: pure ramp lesion, RR type: red–red ramp lesion, and DL type: double longitudinal ramp lesion), and the groups were compared for chronicity of ACL tears and time from injury (TFI). Results Of the 30 patients classified as having PR type lesions, 11 (36.7%) had chronic ACL tears. Likewise, of the 37 patients classified as having RR type lesions, 14 (37.8%) had chronic ACL tears. In contrast, among the 29 patients classified as having DL type lesions, 20 (69.0%) had chronic ACL tears, indicating a statistically significant difference (p < 0.05). This distinction was significant up to 12 months after injury. Conclusions Pure ramp lesions accounted for only 31% of all ramp lesions in ACL tears. In addition, chronic ACL tears are more frequently accompanied by double longitudinal tears than by red–red zone longitudinal tears or pure ramp lesions of the meniscus posterior horn. Study Design: case series, level of evidence IV.https://doi.org/10.1186/s10195-025-00864-9Ramp lesionSubtypeAnterior cruciate ligamentMedial meniscus
spellingShingle Sang-Hoon Roh
Sung-Sahn Lee
Dae-Hee Lee
Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tears
Journal of Orthopaedics and Traumatology
Ramp lesion
Subtype
Anterior cruciate ligament
Medial meniscus
title Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tears
title_full Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tears
title_fullStr Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tears
title_full_unstemmed Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tears
title_short Association between ACL tear chronicity and ramp lesion subtypes: double longitudinal ramp lesions are predominant in chronic ACL tears
title_sort association between acl tear chronicity and ramp lesion subtypes double longitudinal ramp lesions are predominant in chronic acl tears
topic Ramp lesion
Subtype
Anterior cruciate ligament
Medial meniscus
url https://doi.org/10.1186/s10195-025-00864-9
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AT sungsahnlee associationbetweenacltearchronicityandramplesionsubtypesdoublelongitudinalramplesionsarepredominantinchronicacltears
AT daeheelee associationbetweenacltearchronicityandramplesionsubtypesdoublelongitudinalramplesionsarepredominantinchronicacltears