Information about project titled 'Identification, treatment, and time of repair for medial meniscal ramp lesions at time of ACL surgery'
Identification, treatment, and time of repair for medial meniscal ramp lesions at time of ACL surgery
|Details about the project - category||Details about the project - value|
|Project manager:||Nicholas DePhillipo|
|Supervisor(s):||Lars Engebretsen, Robert LaPrade|
Background: Due to the potential hidden nature of medial meniscal ramp lesions and the controversy regarding treatment strategies, it is important to understand the current trends regarding the identification and treatment strategies of meniscal ramp lesions by the leading surgeons and educators in the field of sports medicine.
Aim: The purpose of this research survey was to better understand the current trends in orthopaedic surgery regarding arthroscopic identification and treatment of medial meniscal ramp lesions at the time of anterior cruciate ligament (ACL) surgery.
Methods: An IRB approved questionnaire was electronically sent in a blinded fashion to 91 directors of orthopaedic sports medicine fellowship training programs in the U.S. Participant's email addresses were obtained through the AOSSM directory of current fellowship program directors. Inclusion criteria were only those surgeons who currently perform ACL reconstruction surgery. Exclusion criteria were those surgeons who do not perform ACL reconstruction or chose to opt out of the survey.
Results: Nineteen surgeons opted out of the survey; 36 responded from the remaining 72 surveys (50%). The majority (n=31, 86%) reported routinely checking for a medial meniscus ramp lesion via inspection of the posteromedial meniscocapsular junction during an ACL reconstruction. The most common repair technique reported was all-inside (n=24, 66.7%) followed by inside-out repair technique (n=8, 22.2%). Three (8%) surgeons reported that they do not repair meniscal ramp lesions. Regarding surgical treatment (repair vs. no treatment), the majority reported using the extent of the tear (89%; partial vs. full-thickness) and the stability of the tear upon probing (81%) as the main criteria for intraoperative decision making. Nineteen (52.8%) surgeons reported an average of < 15 minutes required for meniscal ramp repair, 16 (44.4%) reported 15-30 minutes, and one (2.8%) reported 30-45 minutes for the repair time.
Conclusion: This survey provides insight regarding meniscal ramp tear identification, treatment, and repair strategies from the fellowship directors of sports medicine orthopaedic surgery in the U.S. This information may be useful for current orthopaedic surgeons to advance their practice according to the current trends surrounding ACL reconstruction and medial meniscus ramp repair.